Is left atrial size related to left ventricular hypertrophy in hypertensives?

ABSTRACT

The present study was specifically designed to identify the effects of systemic arterial hypertension on the left ventricular and left atrial function analyzed by 2D and M-mode echocardiographic images. The study included two groups Patient group included 30 hypertensive patients with age ranging from 35-70 years [51.5 +/- 10.4]; 11 males [36.7%] and 19 females [63.3%], were subjected to echocardiographic study including 2-dimensional and M-mode. Control group included 15 healthy volunteers with age ranging 35-70 years [51.2 +/- 9.75]; 7 males [46.7%] and 8 females [53.3%]. Statistically, there was no significant difference as regard the age. All patients in the study were subjected to full history taking with special emphasis on valvular heart diseases, congenital heart diseases, ischemic heart disease, medical therapy; especially antiarrhythmic drugs, thorough clinical examination with special emphasis on pulse rate, rhythm, systolic and diastolic blood pressure excluding patients on congestive heart failure, standard 12-lead ECG and echocardiographic examination including 2D and M-mode imaging. The study showed systemic arterial hypertension lead to impairment of left ventricular diastolic function due to increased after load but also the changes of left ventricular geometry and structure producing left ventricular hypertrophy. Also, the left atrium involved in this process by structural abnormalities of the left atrial chamber as regarding by the echo imaging. Individual with systolic arterial hypertension had; 1-ECG finding of LVH. 2-Echoparameters showed increased LAD, LAV, IVS, PWT, RWT, LVM and diastolic dysfunction. 3-Hypertension patients may have LVH or not which may be due to recent incidence or lower level of blood pressure. Hypertension patients without LVH did not show increase in LAD and LAV. 4-Left ventricular hypertrophy could be divided into concentric or eccentric LVH according to present or absence of increase RWT. However LA size and volume were similar in patients with concentric and eccentric LVH. There were positive correlation between LAD and degree of LVH represented by LVM and RWT also LAD positively correlate with LV internal dimension and DT and negatively correlate with E/A ratio