Related Experiment Videos
Right atrial function in hypertensive patients: effects of antihypertensive therapy
1Department of Cardiology, Vostanion Hospital, Mytilini, Greece.
Insights
Antihypertensive drugs improve right atrial (RA) function in patients with essential hypertension. Treatment reduced RA active contribution (RAAC) and left ventricular mass, indicating better cardiac performance.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Essential hypertension is linked to impaired left ventricular diastolic function and disturbed left atrial activity.
- Right atrial (RA) performance may also be affected in hypertensive individuals.
Purpose of the Study:
- To evaluate the 16-week effects of oral antihypertensive drugs on right atrial (RA) function in patients with mild-to-moderate essential hypertension.
- To compare RA function in hypertensive patients with normal subjects using echocardiography.
Main Methods:
- Two-dimensional and Doppler echocardiography were used to assess RA function in 64 hypertensive patients and 32 controls.
- Tricuspid flow velocity curves were analyzed to measure E/A ratio, velocity-time integrals (Ei, Ai), and total time integral (TTi).
- Right atrial active contribution (RAAC) was calculated as Ai/TTi.
Main Results:
- Hypertensive patients exhibited increased RA-A/E ratio, RA-Ai, and RAAC, with decreased RA-TTi compared to controls (P < 0.0001).
- Antihypertensive therapy (ramipril, amlodipine) increased TTi (P < 0.001) and decreased RAAC (P < 0.001) without altering RA dimensions.
- Ramipril showed a greater decrease in RAAC, influenced by reductions in left ventricular mass and right ventricular relaxation (P < 0.001).
Conclusions:
- Right atrial function is impaired in essential hypertension.
- Antihypertensive treatment improves RA performance, associated with reduced blood pressure and left ventricular mass.
- Changes in RA performance during treatment are influenced by left ventricular mass and right ventricular relaxation.
Objectives:
The effects (16 weeks) of oral antihypertensive drugs on right atrial (RA) function were evaluated by two-dimensional and Doppler echocardiography in 64 patients with mild-to-moderate essential hypertension. Thirty-two age- and sex-matched normal subjects served as controls.
Background:
Hypertension alters the diastolic properties of the left ventricle and disturbs the left atrial contractile activities. RA performance may also alter in essential hypertension.
Methods:
From the tricuspid flow velocity curves the E/A ratio, the velocity-time integrals (Ei and Ai, respectively) as well as the sum, TTi = Ei + Ai, were measured. RA active contribution (RAAC) was expressed as the ratio RAAC = Ai/TTi.
Results:
RA-A/E ratio, RA-Ai and RAAC were increased while RA-TTi were decreased in hypertensives compared to controls, P < 0.0001 for all comparisions. After therapy TTi increased (from 13.2 +/- 1.6 to 16.2 +/- 2.0 cm with ramipril, and from 12.9 +/- 1.1 to 14.4 +/- 1.2 cm with amlodipine, P < 0.001) and RAAC decreased (from 0.19 +/- 0.01 to 0.13 +/- 0.01, with ramipril and from 0.19 +/- 0.01 to 0.16 +/- 0.00, with amlodipine P < 0.001) while RA dimensions did not change. the decrease in RAAC was significantly greater with ramipril (P < 0.001) and was significantly influenced by the decrease in left ventricular mass (P < 0.001) and right ventricular relaxation (P < 0.001).
Conclusions:
RA function is deteriorated in patients with essential hypertension. The fall in the arterial blood pressure produced by antihypertensive treatment was associated with improved RA performance and reduced left ventricular mass without changes in RA dimensions. The left ventricular mass and the right ventricular relaxation influenced the changes in RA performance.