The influence of white-coat hypertension on left atrial phasic function

Area of Science:

• Cardiology
• Hypertension Research
• Echocardiography

Background:

• White-coat hypertension (WCH) is characterized by elevated clinic blood pressure (BP) but normal ambulatory BP.
• Left atrial (LA) function is crucial for cardiac health and can be affected by hypertensive conditions.
• Understanding the impact of WCH on LA function is important for early cardiovascular risk assessment.

Purpose of the Study:

• To investigate the association between white-coat hypertension (WCH) and left atrial (LA) phasic function.
• To assess LA volumetric and mechanical properties using echocardiography in normotensive, WCH, and hypertensive individuals.
• To determine the relationship between clinic systolic BP and LA remodeling in the study population.

Main Methods:

• Cross-sectional study involving 52 normotensive, 49 WCH, and 56 untreated hypertensive patients.
• 24-hour ambulatory BP monitoring and two-dimensional echocardiography (2DE) including volumetric and speckle tracking analysis.
• WCH diagnosis based on elevated clinic BP and normal 24-h BP.

Main Results:

• LA volumes and volume indexes significantly increased from normotensive to WCH and hypertensive groups.
• Passive LA emptying fraction (conduit function) decreased, while active LA emptying fraction (booster pump function) increased across these groups.
• LA stiffness index progressively increased from normotensive to WCH and hypertensive subjects; clinic systolic BP correlated with LA functional and mechanical remodeling.

Conclusions:

• White-coat hypertension significantly impacts left atrial phasic function and stiffness.
• Clinic systolic blood pressure is associated with functional and mechanical left atrial remodeling in individuals with WCH.
• These findings highlight the subclinical cardiovascular changes associated with WCH.