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Left ventricular mass but not geometry determines left atrial size in the early stages of hypertension

C Tsioufis1, E Taxiarchou, D Syrseloudis

  • 1First Cardiology Clinic, Hippokration Hospital, University of Athens, Athens, Greece. ktsioufis@hippocratio.gr

Journal of Human Hypertension
|March 6, 2009
PubMed

Insights

In essential hypertension, left atrial size is linked to left ventricular mass, not specific left ventricular geometry patterns. This finding impacts understanding early hypertensive heart disease.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Essential hypertension is a major risk factor for cardiovascular disease.
  • Left ventricular (LV) geometry and left atrial (LA) size are important indicators of cardiac health.
  • The relationship between specific LV geometric patterns and LA size in early hypertension requires clarification.

Purpose of the Study:

  • To investigate the association between different types of left ventricular (LV) geometry and left atrial (LA) size in untreated essential hypertensives.
  • To determine if LA size, measured by diameter or volume, correlates with specific LV geometric patterns.

Main Methods:

  • Echocardiography was used to assess LV structure/function and LA size (diameter and volume indexed to body surface area) in 339 untreated hypertensive patients.
  • 24-hour ambulatory blood pressure monitoring was performed.
  • Patients were categorized into normal geometry (LV-NG), concentric remodeling (LV-CR), concentric hypertrophy (LV-CH), and eccentric hypertrophy (LV-EH).

Main Results:

  • Patients with LV-CH or LV-EH exhibited significantly increased LA diameter and volume indices compared to those with LV-NG or LV-CR.
  • Multiple linear regression identified LV mass index, 24-hour pulse pressure, and E/Em as independent predictors of LA size.
  • LA size was closely related to LV mass index, irrespective of the specific LV geometric pattern.

Conclusions:

  • Left atrial size in early essential hypertension is primarily associated with left ventricular mass index.
  • Specific left ventricular geometric patterns (LV-NG, LV-CR, LV-CH, LV-EH) are not independently related to left atrial size.
  • These findings highlight the importance of LV mass in early hypertensive cardiac remodeling affecting the left atrium.

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