title: Early predictors of alterations in left atrial structure and function related to left ventricular dysfunction in asymptomatic patients with hypertension.
abstract: Our aim was to investigate the relationships between left atrial (LA) structural and functional changes and left ventricular (LV) dysfunction related to LV pressure overload in asymptomatic patients with hypertension. One hundred and twenty-six asymptomatic patients with hypertension and LV ejection fraction (EF) ≥ 60% were studied. Conventional, pulsed and tissue Doppler, and two-dimensional speckle-tracking echocardiography (2DSTE) were performed to seek the independent determinants for alterations in LA structure and function. LA volume index (LAVI) correlated with age, body mass index (BMI), end-diastolic ventricular septal thickness (VSth), end-diastolic LV posterior wall thickness, relative LV wall thickness (RWT), LV mass index, peak A velocity of transmitral flow, E/e', and peak systolic and early diastolic LA strains and strain rates. Peak LA strain during ventricular systole (S-LAs) correlated with age, BMI, heart rate (HR), end-systolic LV diameter, LAVI, VSth, RWT, LVEF, e', E/e', peak systolic LV radial strain, and peak early diastolic LV longitudinal strain rate. Multivariate regression analyses indicated that LV mass index, peak A velocity, E/e', and S-LAs are defined as strong predictors related to LAVI, and that BMI, HR, LAVI, and peak systolic LV radial strain are defined as strong predictors related to S-LAs. In conclusion, 2DSTE demonstrated that alterations in LA structure and function are mainly associated with LV diastolic and systolic dysfunction, respectively, in preclinical patients with hypertension.
authors.affiliation: Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, Tokushima, Japan. hmiyoshi@higasitokusima.hosp.go.jp
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Oishi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Arata
authors.initials: A
authors.lastname: Iuchi
authors.forename: Norio
authors.initials: N
authors.lastname: Nagase
authors.forename: Nusrat
authors.initials: N
authors.lastname: Ara
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*