Masked Hypertension and Left Atrial Dysfunction: A Hidden Association.

Area of Science:

• Cardiology
• Hypertension Research
• Echocardiography

Background:

• Masked hypertension (MH) is defined by normal clinic blood pressure (BP) but elevated 24-hour BP.
• Left atrial (LA) function plays a crucial role in cardiovascular health.
• Understanding LA function in MH is important for risk stratification.

Purpose of the Study:

• To investigate the relationship between masked hypertension and left atrial (LA) phasic function.
• To evaluate LA function using both volumetric and speckle tracking echocardiography.
• To compare LA function in normotensive individuals, patients with MH, and sustained hypertensive patients.

Main Methods:

• Cross-sectional study design.
• Inclusion of 49 normotensive individuals, 50 patients with MH, and 70 untreated sustained hypertensive patients.
• Assessment of LA phasic function via volumetric and 2D strain analysis (speckle tracking).

Main Results:

• Patients with MH and sustained hypertension exhibited reduced LA reservoir function compared to normotensive individuals.
• LA conduit function decreased, while LA booster pump function increased progressively from normotension to sustained hypertension.
• 24-hour systolic BP was independently associated with LA passive ejection fraction, LA total longitudinal strain, LA positive longitudinal strain, and LA stiffness index.

Conclusions:

• Masked hypertension is associated with impaired left atrial (LA) phasic function and altered LA stiffness.
• Elevated 24-hour systolic BP is closely related to left atrial (LA) remodeling in patients with masked hypertension.
• These findings highlight the subclinical cardiac changes associated with masked hypertension.