Key result
Hypertension is linked to persistently lower LA reservoir strain at 12 months, indicating early atrial dysfunction.
Why the study?
To compare left atrial deformation and remodeling in hypertensive versus normotensive adults, and evaluate 12-month longitudinal changes and associations with supraventricular arrhythmia burden and NT-proBNP.
Does hypertension impair left atrial strain and associate with supraventricular arrhythmia burden in adults?
Observational (n=107)
No
Does hypertension impair left atrial strain and associate with supraventricular arrhythmia burden in adults?
Absolute Event Rate: 21.61% vs 26.83%
p-value: p=0.006
In adults with well-controlled hypertension, left atrial strain identifies early atrial dysfunction and increased stiffness, serving as a sensitive marker of arrhythmia risk.
Objective: To compare left atrial (LA) deformation and remodeling in hypertensive versus normotensive adults and to evaluate 12-month longitudinal changes and associations with supraventricular arrhythmia burden and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Design and method: This prospective, single-center observational study included 107 adults (83 with hypertension and 24 normotensive controls) evaluated at baseline and 12 months (August 2024–November 2025). Participants underwent clinical assessment and transthoracic echocardiography with speckle-tracking analysis of LA reservoir, conduit, and contractile strain, LA stiffness index, left atrial volume index, and E/e. Blood pressure control was confirmed by 24-hour ambulatory monitoring, and supraventricular arrhythmias were assessed at follow-up using 24-hour Holter monitoring. Patients with structural heart disease, reduced left ventricular ejection fraction, prior arrhythmias, implanted devices, significant pulmonary disease, pregnancy/lactation, or inadequate image quality were excluded. Results: Hypertensive individuals exhibited persistent impairment of LA mechanics. LASr was significantly lower at baseline (21.66 ± 5.92 vs 26.50 ± 7.67; p = 0.003) and at 12 months (21.61 ± 6.36 vs 26.83 ± 8.01; p = 0.006), while LAScd was similarly reduced at baseline (-12.67 ± 4.78 vs -16.21 ± 4.72; p = 0.003) and follow-up (-11.95 ± 4.65 vs -15.67 ± 5.34; p = 0.005). LASct did not differ between groups. LASI was higher in hypertensive patients at baseline (0.41 ± 0.16 vs 0.32 ± 0.15; p = 0.004) and remained elevated at 12 months (0.42 ± 0.19 vs 0.37 ± 0.33; p = 0.010). LAVI was numerically higher at baseline (+9.1%, p = 0.066) and significantly higher at 12 months (34.0 ± 7.0 vs 29.9 ± 6.5 mL/m2; +13.6%, p = 0.002). E/e values were numerically higher but did not differ significantly. LASr correlated inversely with NT-proBNP at baseline and follow-up, and excessive supraventricular ectopy was associated with worse LA deformation. Conclusions: In adults with well-controlled hypertension, LA strain identifies early atrial dysfunction, increased stiffness, and enlargement despite preserved filling pressures, supporting its role as a sensitive marker of arrhythmia risk.
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Anghel et al. (2026) conducted an observational in Hypertension (n=107). Hypertension vs. Normotensive controls was evaluated on Left atrial reservoir strain (LASr) at 12 months (p=0.006). Hypertension was associated with persistently lower left atrial reservoir strain at 12 months compared to normotensive controls (21.61 vs 26.83; p=0.006), indicating early atrial dysfunction.
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