Left atrial enlargement in essential hypertension: Role in the assessment of subclinical hypertensive heart disease

Alberto Milan, Elisabetta Puglisi, Corrado Magnino, Diego Naso, Sara Abram, Eleonora Avenatti, Franco Rabbia, Paolo Mulatero, Franco Veglio

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background. Arterial hypertension is a common cause of cardiac organ damage, inducing morphofunctional modifications involving left chambers. This is a retrospective study: it was designed to evaluate the additive clinical value of left atrial enlargement (LAe) assessment in the evaluation of cardiac organ damage. Methods. A total of 814 (67% male; aged 50.7 ± 12 years, mean ± SD) essential hypertensive subjects underwent routinely to a complete and extensive clinical and echocardiographic evaluation. Left ventricular morphology, systolic and diastolic function and left atrial dimension (LAD; linear and volumetric) were evaluated. Results. Prevalence of LAe varied between 6.2% and 52.1%, depending on the chosen criteria (left atrial diameter indexed for body surface area (BSA) vs left atrial volume (LAV) indexed for BSA - LAVi). LAVi showed to be the most sensitive parameter in order to detect it (sensitivity 96%, specificity 100%). Left ventricular hypertrophy (LVH) was present in about one fifth of our population (14% and 26%, considering indexation for BSA and for height 2.7). Concentric remodelling (CR) was present in 27-35% of cases considering left ventricular mass indexation for BSA and for height 2.7, respectively. In one quarter of our population, LAe was the only echocardiographic sign of hypertension, independent of LVH and CR. Conclusions. LAV evaluation in hypertensive population can contribute to the identification of subjects affected by hypertensive heart disease other than the conventionally evaluated terms (LVH and CR).

Original languageEnglish (US)
Pages (from-to)88-96
Number of pages9
JournalBlood Pressure
Volume21
Issue number2
DOIs
StatePublished - Apr 2012

Keywords

  • hypertensive cardiomyopathy
  • left atrium
  • left ventricular hypertrophy

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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