Left atrial systolic force and cardiac markers of preclinical disease in hypertensive patients: the Hypertension Genetic Epidemiology Network (HyperGEN) Study.
BACKGROUND
Left atrial systolic force (LASF) has been recently reported to be associated with prolonged left ventricular (LV) relaxation and concentric LV geometry in a clinical setting. This study analyzes the association of increased LASF to LV geometry and function in hypertensive patients from a population study.


METHODS
Doppler echocardiographic findings were examined in 684 subjects with treated hypertension and without prevalent cardiovascular disease from the Hypertension Genetic Epidemiology Network (HyperGEN) Study (426 African American, 448 female, 125 diabetic, 174 obese; age 53.8+/-10.8 years). The LASF was assessed from the mitral orifice area and pulse-wave Doppler peak A flow velocity. The LASF was defined as being high if >14.33 kdynes (90th percentile of the normal distribution in 246 normal adults).


RESULTS
The LASF was high in 269 participants (39.3% of study population), who were older and had higher mean body mass index (all P<.01). Participants with high LASF had higher systolic BP and heart rate (both P<.01) but similar diastolic BP. After controlling for covariates, participants with high LASF exhibited higher LV dimensions and mass than those with normal LASF (all P<.01). The prevalence of LV hypertrophy was also higher (P<.001). Participants with high LASF exhibited normal ejection fraction, higher stroke volume, cardiac output, E and A velocities, slower E deceleration, and lower E/A ratio than those with normal LASF (all P<.01).


CONCLUSIONS
Enhanced LASF is associated with LV hypertrophy, normal LV chamber function, increased cardiac output, and prolonged relaxation. The LASF is a preload-dependent measure.
Chinali
Marcello
M
Department of Medicine, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York 10021, USA.
de Simone
Giovanni
G
Liu
Jennifer E
JE
Bella
Jonathan N
JN
Oberman
Albert
A
Hopkins
Paul N
PN
Kitzman
Dalane W
DW
Rao
Debeeru C
DC
Arnett
Donna K
DK
Devereux
Richard B
RB
D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology; D000465:Algorithms; D016279:Atrial Function, Left / Q000502:physiology*; D044383:Black People; D015992:Body Mass Index; D015331:Cohort Studies; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006334:Heart Function Tests; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D008297:Male; D012737:Sex Factors; D016277:Ventricular Function, Left / Q000502:physiology; D044465:White People; D001741:Black or African American