Predictors of left atrial remodeling in newly diagnosed hypertensive patients: a speckle-tracking echocardiographic study.

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.