PP.08.16

Abstract

Objective: Hypertension(HTN) has severe consequences to the heart, leading to morphological and functional remodeling of left atrium. We sought to assess left atrial(LA) mechanical function in a group of hypertensives, matching it with healthy controls. Design and method: We prospectively enrolled 35 consecutive hypertensive patients (mild, moderate and severe HTN but pharmacological treated subjects). The secondary causes of hypertension, as well as significant valvular disease, thyroid dysfunctions, diabetes mellitus or any other important organ abnormality were excluded. LA diameters(antero-posterior, tranverse and longitudinal) LA volumes were measured by echocardiography, using the modified biplane Simpson method: maximal LA(LAV max), preatrial contraction LA(LAV preA) and minimal LA volume(LAV min). LA emptying functions were calculated: LA total EF(LAV max-LAVmin)/LAV max, LA passive EF = (LAVmax-LAVpreA)/LAVmax and LA active EF(LAVpreA-LAVmin)/LAVpreA. Peak longitudinal strain of LA walls were analysed using 2D speckle-tracking echocardiography. The results were compared with a group of 37 age-matched healthy controls. Results: In the HTN group the mean time of arterial hypertension diagnosis was 33 months and the mean blood pressure(24 hour ambulatory blood pressure monitoring) was 139/74mmHg. LA antero-posterior diameter and all the volumes(LAVmax, LAVmin and LAVpreA) were significantly greater in hypertensives compared to controls(p < 0.0001), while the transversal and longitudinal diameters were similar. LA active EF was similar between the two groups, but we found significantly lower LA passive and total EF in hypertensives than in the control group(p < 0.0001). The peak strain values were also significantly lower in HTN group compared to control(22.7 versus 35.1, p < 0.0001). Conclusions: In our study, arterial hypertension was associated with increased LA size (anteroposterior diameter and volumes), a decrease in LA passive EF and in LA total EF, with preserved atrial pump function. LA dysfunction was also demonstrated through low peak strain values.