LEFT ATRIAL RESERVOIR FUNCTION DECLINES IN HYPERTENSIVE SUBJECTS WITH DYSLIPIDEMIA

Abstract

Objective: Abnormal metabolism of triglycerides and very low density lipoproteins was is involved in structural and electrical atrial remodeling as it was shown in several preclinical studies but data on such relationship with left atrium (LA) function is lacking. As far as we know, the link between LA function and dyslipidemia was never studied in hypertensive patients. We intended to compare LA reservoir function in young hypertensive subjects with or without dyslipidemia. Design and method: We included 87 young subjects (median of age 23 [21; 25] years, mean BMI 25,2 ± 4,5 kg/m2, median 24 hours systolic blood pressure (BP) and diastolic BP (134 [128; 145] and 79 [74,0; 87,0] mm Hg, respectively) with HTN diagnosed with 24-hours ambulatory blood pressure monitoring according to ESH guidelines criteria (2018). None of the patients was taking hypolipidemic drugs at the baseline. Patients were divided in groups according to national criteria for dyslipidemia (fasting total cholesterol > 4,9 mmol/L or low density lipoproteins (LDL) > 3,0 mmol/L or high density lipoproteins (HDL) < 1,0 mmol/L in males and < 1,2 mmol/L in females or triglycerides > 1,7 mmol/L) in which we compared left atrial longitudinal strain during reservoir phase (LASr) ratio and left atrial volume index (LAVI). Results: 58% of patients were diagnosed with dyslipidemia. Left atrial structure and function differed in groups divided according to presence of dyslipidemia: LAVI was higher (24,7 [21,5; 28,3] vs 21,5 [17,9; 26,5] mL/m2, P = 0,045) and LASr was lower (34,9 [30,2; 40,2] vs 40,8 [33,2; 45,5] %, P = 0,017) in patients with dyslipidemia while BP levels were similar. In groups allocated according to isolated criteria for dyslipidemia LASr and LAVI did not differ except patients with or without HDL decrease. Patients with HDL deficiency had lower LASr (33,9 [28,7; 37,8] vs 39,4 [31,8; 43,8] %, P = 0,043) with similar LAVI ranges. Conclusions: Left atrial reservoir function is worse in hypertensive patients with dyslipidemia, in particular in those with HDL deficiency.