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Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
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Echocardiographic characteristics of hypertensive patients affected by transient ischemic attack: a cross-sectional

Daniela Degli Esposti1, Simone Stefano Finzi1, Angelo Parini1

  • 1Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy.

Journal of the American Society of Hypertension : JASH
|June 10, 2017
PubMed

Insights

Atrial septal aneurysm (ASA) with left ventricular concentric remodeling significantly increases the risk of transient ischemic attacks (TIAs). These echocardiographic findings can help identify patients with a history of TIA.

Area of Science:

  • Cardiology
  • Neurology
  • Hypertension Research

Background:

  • Atrial septal aneurysm (ASA) is a common echocardiographic finding.
  • ASA has been linked to transient ischemic attacks (TIAs) and hypertensive end-organ damage like left ventricular (LV) hypertrophy.

Purpose of the Study:

  • To determine if specific echocardiographic features can characterize hypertensive patients with a history of TIA.
  • To investigate the association between ASA, LV geometry, and TIA risk.

Main Methods:

  • A cross-sectional study involving 5223 patients undergoing transthoracic echocardiography at a Hypertension Center.
  • Comparison of 292 TIA patients with 102 age/sex-matched controls without TIA.
  • Analysis included assessment of ASA/bulging, LV concentric remodeling, and mitral flow patterns, with logistic regression for risk factor identification.

Main Results:

  • Atrial septal aneurysm/bulging (ASA/B) was significantly more prevalent in TIA patients (61%) compared to controls (6%).
  • LV concentric remodeling (32.3% vs. 20.8%) and diastolic dysfunction were also more common in TIA patients.
  • Adjusted analysis revealed ASA/B (OR=62.4) and LV concentric hypertrophy (OR=2.1) were strongly associated with TIA history.

Conclusions:

  • ASA/B, particularly when accompanied by LV concentric geometry, significantly increases the likelihood of a TIA history.
  • Relative wall thickness emerged as the strongest TIA-associated factor within the ASA/B subgroup.
  • Echocardiographic assessment of ASA and LV geometry can aid in identifying TIA risk in hypertensive patients.

Keywords:
Atrial septal aneurysmconcentric remodelinghypertrophyleft ventricle

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