title: Left atrial volume and function in patients with white-coat hypertension assessed by real-time three-dimensional echocardiography.
abstract: BACKGROUND
  White-coat hypertension (WCH) is a disease based on the disparity of a patient's blood pressure measurements between the physician's office and the patient's home environment. The aim of the present study is to evaluate the left atrial (LA) volume and functions in WCH.
  
  
  METHODS
  In total, this study included 37 WCH (17 women, 20 men, mean age 48.4±5.7 years) and 30 healthy individuals (18 women, 20 men, mean age 47.9±7.5 years). All patients underwent real-time three-dimensional and comprehensive two-dimensional echocardiography (2DE) with tissue Doppler evaluation to estimate left atrial volumes and mechanical functions.
  
  
  RESULTS
  LA diameters were significantly higher in the patients compared with the controls (37±2.8 vs. 35±3.1 mm, P=0.017). LA total systolic volume and LA maximal volume were significantly higher in the patients. (41.1±6.9 vs. 35.5±3.7 ml, P<0.001; 25.8±5.4 vs. 21.3±3.3 ml, P<0.001, respectively). LA volume before LA contraction and LA active stroke volume were significantly higher in the patients with WCH than in the normotensives (24.4±6.3 vs. 20.9±2 ml, P=0.002; 9.1±4.8 vs. 6.7±2.5 ml, P=0.007, respectively). Moreover, the LA expansion index was significantly higher in the patients with WCH than in the normotensives (178.7±53.6 vs. 155.3±36.3, P=0.037). However, the total emptying volume fraction of the LA was similar between the two groups.
  
  
  CONCLUSIONS
  We showed that LA structural functions and volumes were increased in the WCH group. Although increased LA volume has been observed in many diseases, structural changes in LA may be accepted as an early sign for clinical cardiac remodeling in patients with WCH, suggesting the necessity of early intervention for preventing clinical cardiovascular disease.
authors.affiliation: Departments of aCardiology bCardiovascular Surgery cFamily Medicine, Turgut Özal Medical Center, İnönü University dMalatya State Hospital, Cardiology Clinic, Malatya, Turkey.
authors.forename: Necip
authors.initials: N
authors.lastname: Ermiş
authors.forename: Abdulmecit
authors.initials: A
authors.lastname: Afşin
authors.forename: Bilal
authors.initials: B
authors.lastname: Cuğlan
authors.forename: Nusret
authors.initials: N
authors.lastname: Açikgöz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cansel
authors.forename: Julide
authors.initials: J
authors.lastname: Yağmur
authors.forename: Şiho
authors.initials: Ş
authors.lastname: Hidayet
authors.forename: Mehmet Cengiz
authors.initials: MC
authors.lastname: Colak
authors.forename: Engin Burak
authors.initials: EB
authors.lastname: Selçuk
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D059466:White Coat Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*