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Updated: Nov 5, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Predictors of left atrial remodeling in newly diagnosed hypertensive patients: a speckle-tracking echocardiographic
Eftal Murat Bakirci1, Husnu Degirmenci2, Hikmet Hamur2
1Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey. eftalka@yahoo.com.
Insights
Serum bilirubin may protect against left atrial remodeling in new hypertension cases. Lower bilirubin levels correlate with worse atrial conduction time and reservoir strain, indicating potential protective effects.
Area of Science:
- Cardiology
- Biochemistry
- Hypertension Research
Background:
- Hypertension causes cardiac remodeling via endothelial dysfunction, oxidative stress, and inflammation.
- Bilirubin possesses antioxidant, anti-inflammatory, and anti-fibrotic properties.
- Left atrial remodeling is a significant predictor of cardiovascular events.
Purpose of the Study:
- To investigate the association between serum total bilirubin levels and left atrial (LA) remodeling markers (TACT, LARS) in newly diagnosed hypertensive subjects.
- To identify predictors of LA remodeling in this population.
Main Methods:
- Echocardiography (tissue Doppler imaging, speckle-tracking) was used to assess total atrial conduction time (TACT) and LA reservoir strain (LARS).
- 134 newly diagnosed hypertensive patients were studied, with laboratory parameters recorded.
- Patients were grouped based on median TACT and LARS values.
Main Results:
- Higher TACT and lower LARS were associated with increased LA volume index (LAVI) and epicardial adipose tissue (EAT) thickness.
- Patients with adverse remodeling markers (supramedian TACT, inframedian LARS) were older and had lower total bilirubin levels.
- Serum total bilirubin, EAT thickness, and age were identified as predictors of TACT and LARS.
Conclusions:
- Lower serum bilirubin levels are linked to detrimental left atrial remodeling in newly diagnosed hypertension.
- Bilirubin may exert a protective effect against cardiac remodeling in hypertensive individuals.
- Age and EAT thickness are also significant predictors of atrial function and remodeling.
Abstract:
Endothelial dysfunction, oxidative stress, and increased inflammatory activity are the main pathophysiological mechanisms responsible for cardiac remodeling secondary to hypertension. Bilirubin has anti-oxidant, anti-inflammatory, and anti-fibrotic functions. This report's objectives are to determine whether Query identifiers of left atrial (LA) remodeling, total atrial conduction time (TACT) and LA reservoir strain (LARS), are associated with serum total bilirubin levels, and to identify the possible predictors of LA remodeling in newly diagnosed hypertensive subjects. One hundred thirty-four subjects were enrolled in this study. TACT was evaluated by tissue Doppler imaging, and LARS was calculated by speckle-tracking echocardiography. Laboratory parameters were recorded. The subjects were classified into two separate groups according to the median value of TACT and LARS. In patients with supramedian TACT, LA volume index (LAVI) and epicardial adipose tissue (EAT) thickness were higher, while LARS and LVGLS were lower. In subjects with inframedian LARS, TACT was longer, LAVI and EAT thickness were higher, and LVGLS was lower. Patients with supramedian TACT and inframedian LARS were older and had lower total bilirubin. Total bilirubin, EAT thickness, and age were predictors of TACT and LARS. Serum bilirubin levels may have a protective effect on the LA remodeling process in newly diagnosed hypertensive subjects.
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