Echocardiography features in determining left atrial dilatation in patients with hypertension

Background . The correct echocardiographic (Echo) determination of left atrial (LA) dilatation is a criterion for diagnosing heart failure with the preserved ejection fraction. Objective . The aim is to detect probable reasons for underestimating the LA area by Echo in hypertension patients. Design and methods . In the prospective study, the LA area was measured echocardiographically in 89 ambulatory patients (P-wave duration in standard lead II was > 0.1 mm in 57 patients and ≤ 0.1 mm in 32 patients) from the apical four- and two-chamber views with and without focusing on the LA, and from the subcostal four-chamber view. Results . A strong positive correlation was detected between ECG P-wave duration and the Echo LA area (r = 0.74). The LA areas were revealed to be different in patients with P-wave duration over 0.1 mm from the apical fourchamber view with optimization of displaying the LA (22.33 ± 0.68 and 19.02 ± 0.56 cm 2 , respectively). The maximum LA area was detected from the subcostal fourchamber view (24.41 ± 0.78). Conclusion . Thus, using the correspondence between the LA area and Pwave duration in standard lead II, optimization of displaying the LA, and additionally measuring the LA dimensions from the subcostal view, sonologists can avoid underestimating LA dimensions.