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Left ventricular mass and atrial volume determined by cine magnetic resonance imaging in essential hypertension
K Mineoi1, Y Shigematsu, T Ochi
1Department of Internal Medicine, Takanoko Hospital, Japan.
Insights
Left ventricular hypertrophy (LVH) causes left atrial enlargement. Effective antihypertensive therapy can reverse both LVH and left atrial enlargement, improving cardiac chamber volumes.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a common complication of hypertension.
- Left atrial enlargement is often associated with LVH, but the direct relationship requires further investigation.
- Understanding the impact of antihypertensive therapy on cardiac remodeling is crucial.
Purpose of the Study:
- To assess the correlation between left atrial volume and left ventricular mass (LVM) in hypertensive patients.
- To investigate the effect of antihypertensive therapy on left atrial volume and LVM.
- To determine if LVH is an independent predictor of left atrial enlargement.
Main Methods:
- Cine magnetic resonance imaging (MRI) and echocardiography were used to measure cardiac chamber volumes and LVM.
- 30 hypertensive patients (with and without LVH) and 10 normotensive controls were studied.
- Cardiac volumes and LVM were indexed by body surface area and analyzed before and after antihypertensive treatment.
Main Results:
- Hypertensive patients with LVH exhibited significantly greater left atrial volume indexes and LVM index compared to controls and hypertensive patients without LVH.
- A strong positive correlation was found between LVM index and both maximum and minimum left atrial volume indexes (r=0.74 and r=0.76, respectively).
- Antihypertensive therapy led to significant reductions in left atrial volume indexes and LVM index in hypertensive patients with LVH.
Conclusions:
- Left ventricular hypertrophy is an independent determinant of left atrial enlargement.
- Both LVH and left atrial enlargement are reversible with effective therapeutic interventions.
- Cardiac MRI and echocardiography are valuable tools for assessing cardiac remodeling in hypertension.
Abstract:
To evaluate the relationship between left atrial volume determined by cine magnetic resonance imaging and progression of left ventricular hypertrophy (LVH), left atrial volume and echocardiographic left ventricular mass (LVM) were measured in 30 hypertensive patients (15 without LVH and 15 with LVH) and 10 normotensive control subjects. We also evaluated the effects of antihypertensive therapy on the cardiac chamber volumes and LVM in hypertensive patients. The cardiac chamber volumes and LVM were indexed by body surface area. Although there were no significant differences in left ventricular chamber volumes among the three groups, both maximum and minimum left atrial volume indexes, and the LVM index were greater in hypertensive patients with LVH than in the other two groups. The LVM index was correlated with maximum left atrial volume index (r = 0.74, P < .0001), and minimum left atrial volume index (r = 0.76, P < .0001), respectively. Furthermore, in multivariate models, the LVM index was significantly correlated with maximum left atrial volume index. In hypertensive patients with LVH, both maximum and minimum left atrial volume indexes, and the LVM index significantly reduced after treatment. The percent of changes in maximum left atrial volume index after treatment was significantly correlated with the percent of changes in LVM index after treatment. In conclusion, our data indicate that LVH is an independent determinant of left atrial enlargement, and both LVH and left atrial enlargement may be reversed by some effective therapeutic interventions.