title: Left atrial enlargement in essential hypertension: role in the assessment of subclinical hypertensive heart disease.
abstract: BACKGROUND
  Arterial hypertension is a common cause of cardiac organ damage, inducing morphofunctional modifications involving left chambers. This is a retrospective study: it was designed to evaluate the additive clinical value of left atrial enlargement (LAe) assessment in the evaluation of cardiac organ damage.
  
  
  METHODS
  A total of 814 (67% male; aged 50.7 ± 12 years, mean ± SD) essential hypertensive subjects underwent routinely to a complete and extensive clinical and echocardiographic evaluation. Left ventricular morphology, systolic and diastolic function and left atrial dimension (LAD; linear and volumetric) were evaluated.
  
  
  RESULTS
  Prevalence of LAe varied between 6.2% and 52.1%, depending on the chosen criteria (left atrial diameter indexed for body surface area (BSA) vs left atrial volume (LAV) indexed for BSA - LAVi). LAVi showed to be the most sensitive parameter in order to detect it (sensitivity 96%, specificity 100%). Left ventricular hypertrophy (LVH) was present in about one fifth of our population (14% and 26%, considering indexation for BSA and for height(2.7)). Concentric remodelling (CR) was present in 27-35% of cases considering left ventricular mass indexation for BSA and for height(2.7), respectively. In one quarter of our population, LAe was the only echocardiographic sign of hypertension, independent of LVH and CR.
  
  
  CONCLUSIONS
  LAV evaluation in hypertensive population can contribute to the identification of subjects affected by hypertensive heart disease other than the conventionally evaluated terms (LVH and CR).
authors: Department of Medicine and Experimental Oncology, Division of Internal Medicine, Hypertension Unit, University Hospital "S. Giovanni Battista", Torino, Italy. alberto.milan@unito.it
authors: Alberto
authors: A
authors: Milan
authors: Elisabetta
authors: E
authors: Puglisi
authors: Corrado
authors: C
authors: Magnino
authors: Diego
authors: D
authors: Naso
authors: Sara
authors: S
authors: Abram
authors: Eleonora
authors: E
authors: Avenatti
authors: Franco
authors: F
authors: Rabbia
authors: Paolo
authors: P
authors: Mulatero
authors: Franco
authors: F
authors: Veglio
mesh_terms: D000328:Adult; D000368:Aged; D006332:Cardiomegaly / Q000453:epidemiology*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies