title: Left atrial size in hypertension and stroke.
abstract: BACKGROUND
  An enlarged left atrium is associated with increased risk for stroke. However, there are controversies regarding how left atrial size should be measured.
  
  
  METHODS
  Echocardiography and carotid artery ultrasound were performed in 120 patients with essential hypertension (HT group) and in 64 hypertensive patients admitted with a first-ever ischemic stroke (HT-stroke group). Left atrial size was measured as antero-posterior diameter (LAD) and as left atrial volume (LAV) and indexed to body surface area (LADi/LAVi). All patients were in sinus rhythm and without mitral valve disease.
  
  
  RESULTS
  In the HT-stroke group, LAVi and LADi were significantly larger as compared with the HT group (P ≤ 0.03 for all). In bivariate correlations, larger left atrial size was associated with higher SBPs and DBPs and significant carotid artery stenosis both in HT and HT-stroke groups (all P < 0.05). In multivariate logistic regression analysis, stroke was associated significantly with larger LAVi [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.06-2.65]; left ventricular mass index (OR 1.11, 95% CI 1.03-1.21); significant carotid artery stenosis (OR 1.09, 95% CI 1.03-1.24); and any carotid artery stenosis (OR 1.07, 95% CI 1.03-1.14). Analysis of receiver operating characteristic curves revealed that LAVi was the best left atrial measurement for prediction of stroke (OR 0.77, 95% CI 0.70-0.84).
  
  
  CONCLUSIONS
  In hypertensive patients, a first-ever ischemic stroke was associated with larger left atrial size, left ventricular mass index and internal carotid artery stenosis. LAVi was the left atrial measurement most closely associated with ischemic stroke.
authors: Department of Cardiology, Nicolas Copernicus Specialist District Hospital in Lodz, Poland. gpiotr4@wp.pl
authors: Grzegorz
authors: G
authors: Piotrowski
authors: Maciej
authors: M
authors: Banach
authors: Eva
authors: E
authors: Gerdts
authors: Dimitri P
authors: DP
authors: Mikhailidis
authors: Simon
authors: S
authors: Hannam
authors: Rafał
authors: R
authors: Gawor
authors: Arkadiusz
authors: A
authors: Stasiak
authors: Jacek
authors: J
authors: Rysz
authors: Zenon
authors: Z
authors: Gawor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*