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Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

Marcello Chinali1, Giovanni de Simone, Kristian Wachtell

  • 1Weill Medical College of Cornell University, New York, NY 10021, USA.

Journal of Hypertension
|June 14, 2008
PubMed

Insights

Enhanced left atrial systolic force in hypertensive patients indicates greater left ventricular mass and hypertrophy, but normal systolic function, suggesting increased preload. This finding is crucial for cardiovascular risk assessment.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Hypertension Research

Background:

  • Enhanced left atrial systolic force is linked to left ventricular hypertrophy and increased preload in hypertensive patients.
  • Previous studies suggest left atrial systolic force predicts cardiovascular events, particularly in obese populations.
  • The relationship between left atrial systolic force and left ventricular geometry/function in high-risk hypertensive patients remains under-investigated.

Purpose of the Study:

  • To investigate the association between left atrial systolic force and left ventricular geometry and function in high-risk hypertensive patients.
  • To determine if enhanced left atrial systolic force is linked to specific echocardiographic findings in this population.

Main Methods:

  • Utilized data from the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy (n=567).
  • Assessed left atrial systolic force using mitral orifice area and Doppler mitral peak A velocity from standard Doppler echocardiography.
  • Categorized patients into normal or increased left atrial systolic force groups (>14.33 kdyn).

Main Results:

  • Increased left atrial systolic force was observed in 52.3% of patients, associated with older age, higher BMI, and heart rate.
  • After adjusting for confounders, higher left atrial systolic force correlated with larger left ventricular diameter and increased left ventricular mass index.
  • Patients with enhanced left atrial systolic force showed a higher prevalence of left ventricular hypertrophy (84% vs. 64%) and increased transmitral flow during early filling, indicative of higher preload, despite normal ejection fraction.

Conclusions:

  • Enhanced left atrial systolic force identifies hypertensive patients with greater left ventricular mass and hypertrophy.
  • This finding is associated with normal left ventricular chamber systolic function but increased transmitral flow gradient, suggesting elevated preload.
  • Left atrial systolic force may serve as a valuable indicator of cardiac remodeling and preload status in hypertensive individuals.

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