Early detection by non-invasive methods of predisposition to atrial remodeling in hypertension

Hypertension (persistently high blood pressure levels) is one of the main cardiovascular risk factors.It causes pressure overload that leads to the structural and electrical alterations known as atrial remodeling. 1,2The consequences are seen at various levels, especially in increased risk for atrial fibrillation (AF), which worsens with increasing age. 3 AF has a significant impact on cardiac output and is associated with a 4-5-fold higher risk of cardioembolic ischemic stroke, 4,5 as well as a considerably higher risk of death. 6nteratrial electromechanical delay and prolonged total atrial activation time have been linked to a higher incidence of AF. 3,7,8 Increased atrial conduction time is an indication of structural and electrical remodeling, which left atrial (LA) size and LA volume index are not. 1,9ncreased left ventricular (LV) mass index is associated with prolonged interatrial conduction time and LA electromechanical coupling interval. 1The severity of LV hypertrophy appears to be one of the factors associated with the onset of AF.It has been demonstrated that pharmacological treatment that reduces blood pressure (BP) and hence LV mass makes AF less likely to occur. 10---12