doiSerbia

Left atrial size in patients with arterial hypertension

Milutinović Suzana (Porodični dispanzer 'Varnava', Niš)
Apostolović Svetlana (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Tasić Ivan (Institut za kardiovaskularne bolesti, Niška Banja)

INTRODUCTION Left atrial size is increased in patients with arterial hypertension. Left atrial enlargement represents a risk factor of atrial fibrillation and stroke. Left atrial size depends on the effect of many other etiological factors, predominantly by body mass and the left ventricular mass. OBJECTIVE The objective of the study was to investigate the frequency of the left atrial enlargement in patients with arterial hypertension, in obese patients with arterial hypertension and in patients with arterial hypertension and left ventricular hypertrophy. In addition, the aim was to investigate the influence of diastolic function parameters on the left atrial dimension. METHOD The study included 93 patients with arterial hypertension (mean age of 46.9 ± 9.7 years, 50.5% of males) and 33 healthy subjects (mean age 45.6 ±10.6 yrs., 40% of males) who consisted the control group. There was no statistical difference of the age and sex between patients and healthy persons. All patients were examined by the echocardiographic ultrasound device HP Sonos 2500 by three echosonographers. RESULTS The patients with arterial hypertension compared to the control group had significantly higher: body mass index (27.8 ± 4.1 versus 24.3 ± 3.0) (p<0.001), the left ventricular mass (249.7 ± 79.1 versus 174.6 ± 47.7) (p<0,001), the left ventricular mass index (122.2 ± 34.3 versus 96.7 + 20.9)(p<0.001) and the left atrium (3.8 ± 0.7 versus 3.3 ± 0.5) (p<0.001). The frequency of the left atrial enlargement in patients with arterial hypertension was 44.1%. The frequency of the left atrial enlargement In patients with arterial hypertension and the left ventricular hypertrophy was 53.3%, and in obese patients with arterial hypertension was 58.3%. Left ventricular diastolic function parameters in patients with arterial hypertension in relation to control exhibited statistically significant differences: isovolumetric relaxation time (IVRT) was longer (193.2 ± 37.8 versus 175,8 ± 23,6) (p<0.001), deceleration time (DT) was longer (193.2 ±37,8 versus 175.8 ±23.6) (p<0.01) and peak early diastolic filling wave velocity /peak atrial diastolic filling wave velocity ratio (E/A ratio) was lower (1.0 ± 0.3 versus 1.2 ± 0.3) (p<0.01). The quotient of linear correlation of the left ventricular diastolic function parameters in patients with arterial hypertension with left atrial volume did not show any significant correlation. CONCLUSION The left atrial size was statistically bigger in patients with arterial hypertension in relation to healthy subjects. The biggest left atrial enlargement was in hypertensive patients with the left ventricular hypertrophy and obese hypertensive patients. Left ventricular diastolic function parameters in patients with arterial hypertension had no statistically significant influence on the left atrial size.

Keywords: left atrium, arterial hypertension, obesity, left ventricular hypertrophy, left ventricular diastolic function