Right atrial function in hypertensive patients: effects of antihypertensive therapy.
OBJECTIVE
The effects (16 weeks) of oral antihypertensive drugs on right atrial (RA) function were evaluated by two-dimensional and Doppler echocardiography in 64 patients with mild-to-moderate essential hypertension. Thirty-two age- and sex-matched normal subjects served as controls.


BACKGROUND
Hypertension alters the diastolic properties of the left ventricle and disturbs the left atrial contractile activities. RA performance may also alter in essential hypertension.


METHODS
From the tricuspid flow velocity curves the E/A ratio, the velocity-time integrals (Ei and Ai, respectively) as well as the sum, TTi = Ei + Ai, were measured. RA active contribution (RAAC) was expressed as the ratio RAAC = Ai/TTi.


RESULTS
RA-A/E ratio, RA-Ai and RAAC were increased while RA-TTi were decreased in hypertensives compared to controls, P < 0.0001 for all comparisions. After therapy TTi increased (from 13.2 +/- 1.6 to 16.2 +/- 2.0 cm with ramipril, and from 12.9 +/- 1.1 to 14.4 +/- 1.2 cm with amlodipine, P < 0.001) and RAAC decreased (from 0.19 +/- 0.01 to 0.13 +/- 0.01, with ramipril and from 0.19 +/- 0.01 to 0.16 +/- 0.00, with amlodipine P < 0.001) while RA dimensions did not change. the decrease in RAAC was significantly greater with ramipril (P < 0.001) and was significantly influenced by the decrease in left ventricular mass (P < 0.001) and right ventricular relaxation (P < 0.001).


CONCLUSIONS
RA function is deteriorated in patients with essential hypertension. The fall in the arterial blood pressure produced by antihypertensive treatment was associated with improved RA performance and reduced left ventricular mass without changes in RA dimensions. The left ventricular mass and the right ventricular relaxation influenced the changes in RA performance.
Dernellis
J
J
Department of Cardiology, Vostanion Hospital, Mytilini, Greece.
D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016280:Atrial Function, Right / Q000187:drug effects*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000494:pharmacology / Q000627:therapeutic use
D000959:Antihypertensive Agents; D017311:Amlodipine; D017257:Ramipril