title: Left atrial appendage function in prediction of paroxysmal atrial fibrilation in patients with untreated hypertension.
abstract: Abstract The onset of AF results in a significant increase in mortality rates and morbidity in hypertensive patients and this rhythm disorder exposes patients to a significantly increased risk of cerebral or peripheral embolisms. Tissue Doppler imaging was found to be useful in early detection of myocardial dysfunction in several diseases. It was shown that tissue Doppler analysis of the walls of the left atrial appendage (LAA) can give accurate information about the function of the LAA in hypertensive patients. In this study, we aimed to investigate and identify the specific predictive parameters for the onset of AF in patients with hypertension with tissue Doppler imaging of LAA. We studied age and sex matched 57 untreated hypertensive patients with paroxysmal atrial fibrillation (PAF) and 27 untreated hypertensive subjects without PAF. With transthoracic echocardiography, diastolic mitral A-velocity and LA maximal volume index which reflects reservoir function of left atrium was measured, with transesophageal echocardiography, LAA emptying velocity (LAA-PW D2) and tissue Doppler contracting velocity of LAA (LAA-TDI-D2) were measured. LA maximal volume index of the groups (22.28 ± 3.59 mL/m(2) in Group 1 versus 20.37 ± 3.97 mL/m(2) in Group 2, p = 0.07) and diastolic mitral A-velocity [0.93 (0.59-1.84) m/s in patients with PAF versus 0.90 (0.62-1.76) m/s in patients without PAF, p = 0.26] was not significantly different between study groups, during TEE, LAA-PW D2 (0.31 ± 0.04 m/s in Group 1 versus 0.33 ± 0.03 m/s in Group 2, p = 0.034) and LAA-TDI-D2 (0.18 ± 0.04 m/s in Group 1 versus 0.21 ± 0.05 m/s in Group 2, p = 0.014) were significantly decreased in Group 1. In this study, we found that in hypertensive PAF patients despite normal global LA functions, LAA contracting function was deteriorated. Tissue Doppler analysis of LAA is clinically usefull approach to detect the risk of developing PAF in hypertensives.
authors.affiliation: Department of Cardiology, Bursa Yuksek Ihtisas Education and Resarch Hospital , Bursa , Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioglu
authors.forename: Fahriye Vatansever
authors.initials: FV
authors.lastname: Agca
authors.forename: Kemal
authors.initials: K
authors.lastname: Karaagac
authors.forename: Ozlem Arican
authors.initials: OA
authors.lastname: Ozluk
authors.forename: Tezcan
authors.initials: T
authors.lastname: Peker
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kuzeytemiz
authors.forename: Muhammed
authors.initials: M
authors.lastname: Senturk
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yılmaz
mesh_terms: D000328:Adult; D000368:Aged; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
keywords: Hypertension; left atrial appendage; left atrium; paroxysmal atrial fibrillation; tissue Doppler imaging