Left Atrium Function in Systemic Hypertension

Objective: Assessment of left atrium (LA) deformation by 2-Dimensional Speckle Strain Imaging (2DSI) has been recently proposed as an alternative method of exploring LA function. The purpose of this study was to assess the relationship of LA function, particularly reservoir function, with LA structural remodeling related to left ventricular hypertrophy (LVH) in patients with hypertension (HTN) using conventional, tissue Doppler, and 2-Dimensional speckle-tracking echocardiography (STE). Methods: Two hundred patients with systemic hypertension and fifty age and gender matched controls underwent routine transthoracic echocardiography and speckle tracking study of the left atrium. LA volume was calculated by the biplane method of disks (modified Simpson's rule). Peak early diastolic transmitral flow velocity/peak early diastolic mitral annular motion velocity (E/Em)/peak systolic LA strain was defined as LA diastolic stiffness Results: Hypertensive patients were classified to group I with Left ventricle hypertrophy (LVH) (75% n= 150) and group II without LVH (25% n=50). LV Mass was 132.7 +-16.5g in control and 218.2+-60.4 grams in study population. Left atrium volume indexed to body surface area was 19.4+-3.4 versus 27.4+3.3 ml/m in controls and hypertensive subjects respectively. (P value 0.000). Left atrium anteroposterior diameter was higher in the hypertensive group 4.22+-0.56 versus 3.4+-0.26 cm in control group (P value 0.000) Using STE left atrial longitudinal strain was 26.05+-3.08 in hypertensive patients and 33.7+-2.1 among controls ( P<0.000). Conclusion: Speckle tracking imaging might be required to detect early impairment of LA function in hypertension