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J Cardiol. 2014 Apr;63(4):291-5. doi: 10.1016/j.jjcc.2013.09.006. Epub 2013 Oct 29.

Comparison between left atrial features in well-controlled hypertensive patients and normal subjects assessed by three-dimensional speckle tracking echocardiography.

Author information

  • 1Department of Echo Laboratory, Gifu Prefectural General Medical Center, Gifu, Japan.
  • 2Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan. Electronic address: masanori@ya2.so-net.ne.jp.
  • 3Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan.
  • 4Department of Cardiology, Sawada Hospital, Gifu, Japan.
  • 5Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.

Abstract

BACKGROUND:

Three-dimensional speckle tracking echocardiography (3D-STE) has a major advantage in the improvement of accuracy in the evaluation of cardiac chamber volume without any geometrical assumption. Thus, the aim of this study was to use 3D-STE to elucidate the features of left atrial (LA) volume and function that are altered by hypertension (HTN) by comparing well-controlled HTN patients with normal subjects.

METHODS:

Conventional echocardiographic parameters and LA phasic volume and function were measured from apical view by 3D-STE in 40 patients with well-controlled HTN [systolic blood pressure (BP) <140 and diastolic BP <90mmHg for more than one year] and 40 normotensive subjects.

RESULTS:

The passive LA emptying function (EF) in the patients with well-controlled HTN significantly decreased (16±7% vs. 22±8%, p=0.0013) and the active LAEF in patients with well-controlled HTN significantly increased (35±10% vs. 30±9%, p=0.029) compared with the values in normotensive subjects. Multivariate logistic regression analysis revealed that E/e' was an independent determinant of well-controlled HTN. The maximum LA volume index was correlated with elevated E/e' (r=0.30, p=0.0064), whereas the maximum LA volume index was not correlated with LV mass index or systolic BP. This change was independent of age.

CONCLUSIONS:

These results suggest that LV diastolic dysfunction occurs before structural changes of left atrium and left ventricle even in patients with well-controlled HTN.

Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:

Atrial function; Atrial volume; Hypertension; Speckle tracking; Three-dimensional echocardiography

PMID:
24182422
[PubMed - indexed for MEDLINE]
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