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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Left atrial size in patients with arterial hypertension]
Insights
Arterial hypertension significantly increases left atrial size, a risk factor for atrial fibrillation and stroke. This enlargement is most pronounced in hypertensive patients with obesity or left ventricular hypertrophy, independent of diastolic function.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Arterial hypertension is linked to increased left atrial size, a known risk factor for atrial fibrillation and stroke.
- Left atrial size is influenced by factors such as body mass and left ventricular mass.
Purpose of the Study:
- To determine the prevalence of left atrial enlargement in patients with arterial hypertension, particularly in those who are also obese or have left ventricular hypertrophy.
- To assess the impact of diastolic function parameters on left atrial dimensions in hypertensive individuals.
Main Methods:
- Echocardiography was used to examine 93 patients with arterial hypertension and 33 healthy controls.
- Demographic and clinical data, including body mass index and left ventricular mass, were collected and analyzed.
Main Results:
- Hypertensive patients exhibited significantly higher body mass index, left ventricular mass, and left atrial size compared to controls.
- Left atrial enlargement was observed in 44.1% of hypertensive patients, rising to 53.3% with left ventricular hypertrophy and 58.3% with obesity.
- While diastolic function parameters differed significantly, they did not correlate with left atrial size in hypertensive patients.
Conclusions:
- Left atrial size is significantly larger in patients with arterial hypertension compared to healthy individuals.
- Hypertensive patients with left ventricular hypertrophy and obesity show the most substantial left atrial enlargement.
- Left ventricular diastolic function parameters do not significantly influence left atrial size in patients with arterial hypertension.
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.
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