Echocardiographic and laboratory parameters in hypertensive patients with and without atrial fibrillation

Background. Arterial hypertension (AH) is the most common cause of atrial fibrillation (AF). During AF, the contractile function of the left atrium (LA) is lost, and structural and functional remodeling occur. AH contributes greatly to the development of this common arrhythmia. The main objective of our study was to compare echocardiographic and laboratory biomarkers in patients with AH with or without AF. Methods We conducted a cross-sectional analysis with 97 consecutive patients (mean age, 64±9 years; 49 male) with AH, 56 patients (57.7%) with AF. All patients underwent a basic examination and measurement of blood pressure. Laboratory testing (brain natriuretic peptide (BNP), C-reactive protein (CRP)), and transthoracic echocardiography examination with assessment of the LA anteroposterior (AP) diameter from the longitudinal parasternal section, and medio-lateral (ML) and superior-inferior (SI) dimension from the four-cavity apical section was performed. Results. In two groups, there was no difference in blood pressure values. Mean systolic arterial pressure was slightly higher in the group of patients with AF (133,1±17,4 mmHg) compared with the group without AF (129,3±20,6 mmHg; t=0,991; p=0,324). Diastolic blood pressure values did not differ between groups (with AF 77,5±12,7mmHg, without AF 78,4±10,8mmHg, t=-0,348; p=0,729). Slightly increased values of CRP were in the group of patients with AF, but the difference was not statistically significant (2.5±1.2mg/L; 3.6±2.1mg/L, Z=-1.618; p=0.106). Also, there was significant difference between groups regarding the BNP (46±23 pg/ml, 89±55 pg/ml, Z=-3,838; p<0,001). Between the two groups, all echocardiographic measurements of the LA showed significant differences (AP 45,43±5.02mm with AF; 39.37±6.05mm, t=5.392, p<0,01, ML 58.57±7.69mm with AF; 50.12±8.01mm, t= 5.253, p<0,001, SI 47.43±6.35 mm with AF, 43.85±5.47 mm, t=2.9, p=0.005). As predictors of AF in hypertensive patients we found echocardiographic parameter – ML dimension of the LA and laboratory marker BNP. Conclusion. Hypertensive patients with AF have a significantly increased LA compared with hypertensive patients in sinus rhythm. Predictors of AF in AH are ML dimension of LA and elevated value of BNP.