Blood pressure levels, left ventricular mass and function are correlated with left atrial volume in mild to moderate hypertensive patients

• Published in: Journal of human hypertension Vol. 23; no. 11; pp. 743 - 750
• Main Authors: Milan, A, Caserta, M A, Dematteis, A, Naso, D, Pertusio, A, Magnino, C, Puglisi, E, Rabbia, F, Pandian, N G, Mulatero, P, Veglio, F
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2009; Nature Publishing Group
• Subjects: Adult; Age; Age Factors; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - etiology; Atrial Fibrillation - physiopathology; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Body Mass Index; Cardiology. Vascular system; Case-Control Studies; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Complications and side effects; Control; Diagnosis; Drug therapy; Echocardiography, Doppler; Epidemiology; Fibrillation; Health Administration; Heart; Heart Atria - diagnostic imaging; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension; Hypertension - complications; Hypertension - diagnostic imaging; Hypertension - drug therapy; Hypertension - physiopathology; Hypertrophy; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Linear Models; Measurement; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Multivariate analysis; original-article; Patients; Predictive Value of Tests; Public Health; Risk Assessment; Risk Factors; Severity of Illness Index; Structure-function relationships; Variables; Ventricle; Ventricular Function, Left; United States; Italy; diastolic function; left ventricular mass; left atrial volume; Human; Hypertension; Cardiovascular disease; Arterial pressure; Blood pressure; Left atrium; Left ventricle performance; Left ventricle
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2009.15

Arterial hypertension is associated with an increased risk of atrial fibrillation (AF), and leads to a pronounced increase in morbidity and mortality. Left atrial volume (LAV) is an important prognostic marker in the older populations. The aim of our study was to identify the clinical and echocardiographic determinants of LAV in middle-aged (<70 years old) essential hypertensive patients.We evaluated cardiac structure and function in 458 patients, 394 treated and untreated mild to moderate essential hypertensives patients (mean±s.d. age 48.4±11.1 years) with no associated clinical condition and 64 normotensive control participants (age 45.7±12.8 years; P =0.12). A multivariate analysis was performed to calculate the relative weight of each of the variables considered able to predict LAV. The LAV index (LAVi) was significantly increased in the essential hypertensive group vs the control group and was significantly dependent on blood pressure levels (SBP and DBP, P <0.05 for both) and body mass index (BMI) ( P <0.0001). Considering the left ventricular (LV) variables, the LV mass index (LVMI) ( R 2 =0.19, P <0.001) and LAV were increased in essential hypertensive patients with left ventricular hypertrophy (LVH), and patients with enlarged LAV showed lower systolic and diastolic function and an increased LVMI. The LAVi is dependent on blood pressure levels and anthropometric variables (age and BMI). Further structural (LVMI) and functional (systolic and diastolic) variables are related to the LAVi; LVMI is the most important variable associated with LAV in mild to moderate essential hypertensive adult patients. These findings highlight the importance of left atrium evaluation in adult, relatively young, essential hypertensive patients.