Hypertension significantly alters left atrial dynamics, leading to increased left atrial volume and diastolic stiffness related to left ventricular dysfunction in asymptomatic patients.
Observational (n=190)
Hypertension significantly alters left atrial dynamics, leading to increased volume and diastolic stiffness related to left ventricular dysfunction even in asymptomatic patients.
Left atrial (LA) structural and functional abnormalities are vital steps on the pathway toward heart failure with preserved ejection fraction in asymptomatic patients. The purpose of this study was to assess the relationship of LA function, particularly reservoir function, with LA structural remodeling related to the left ventricular (LV) dysfunction in asymptomatic patients with hypertension (HT) using conventional, tissue Doppler, and 2-D speckle-tracking echocardiography. Fifty age-matched healthy individuals and 140 patients with HT, including 75 with LA volume index (LAVI)<29 ml/m2 (normal LA group) and 65 with LAVI≥29 ml/m2 (large LA group), were enrolled. We defined peak early diastolic transmitral flow velocity/peak early diastolic mitral annular motion velocity (E/e')/peak systolic LA strain (S-LAs) as LA diastolic stiffness. The LV mass index, relative LV wall thickness, peak atrial systolic transmitral flow velocity, LA total, active, and passive emptying volume indexes, and E/e'/S-LAs were greatest, and S-LAs, peak early diastolic LA strain, peak systolic LV longitudinal strain and circumferential strain rate, and peak early diastolic LV radial strain rate were lower in the large LA group compared with control and/or normal LA group. Multivariate linear regression analysis revealed that aging, LA remodeling, and LV systolic and diastolic dysfunction are defined as strong predictors related to increased LA diastolic stiffness in the large LA group. HT alters LA dynamics significantly, with resultant increased LA volume and diastolic stiffness related to LV diastolic and systolic dysfunction, even in asymptomatic patients. Earlier treatment with reninangiotensin system inhibitors may improve abnormal LA-LV interaction in this patient population.
Miyoshi et al. (Tue,) conducted a observational in Asymptomatic hypertension (n=190). Hypertension with large left atrial volume (LAVI ≥29 ml/m2) vs. Healthy individuals and hypertension patients with normal left atrial volume (LAVI <29 ml/m2) was evaluated on Relationship of left atrial reservoir function with left atrial structural remodeling and left ventricular dysfunction. Hypertension significantly alters left atrial dynamics, leading to increased left atrial volume and diastolic stiffness related to left ventricular dysfunction in asymptomatic patients.