Relationship between left atrial deformation and left ventricular diastolic dysfunction in hypertensive patients: A strain rate imaging study

Abstract

Objectives The present study was designed to investigate the relationship between left atrial (LA) myocardial function and left ventricular (LV) diastolic dysfunction by strain rate imaging. Design and methods 48 essential hypertensive patients and 21 age-matched normal controls were included in the study. LV diastolic dysfunction was classified into no, mild, moderate, and severe groups by using conventional echocardiography and tissue Doppler imaging (TDI). Peak strain rate in the systole (S-Sr), early diastole (E-Sr) and late diastole (A-Sr) was obtained from Doppler derived strain rate imaging to evaluate the LA myocardial deformation. Association between LA myocardial deformation and ratio of mitral peak E velocity to mitral annulus early diastolic velocity (E/Em ratio) was assessed by Pearson correlation coefficient. Results E-Sr was significantly lower in hypertensive patients than normal controls (0.88±0.35 s−1 vs 1.04±0.18 s−1, p=0.028). All the LA myocardial parameters including S-Sr, E-Sr and A-Sr were significantly correlated with E/Em (r=−0.50, −0.528, and −0.360 respectively, all p≤0.015). Similar LA dimension was observed in patients with different degrees of LV diastolic dysfunction while LA myocardial strain rate parameters were all significantly reduced in patients with moderate diastolic dysfunction compared with patients with no diastolic dysfunction (all p<0.001). Compared with patients of no diastolic dysfunction, the mild diastolic dysfunction group had significantly lower E-Sr (0.76±0.34 s−1 vs 1.17±0.40 s−1, p<0.001) but preserved S-Sr and A-Sr. Conclusions Left atrial myocardial deformation is impaired in hypertensive patients, and is closely associated with different degrees of LV diastolic dysfunction. Quantification of the LA early diastolic strain rate rather than LA size may have the potential to predict early LV diastolic dysfunction in hypertensive patients.