P-396: Left atrium dilatation dependent on left ventricular diastolic function in hypertensive patients with or without coronary artery disease:

Abstract

Introduction:

Left atrium dilatation (LAD) is a frequent finding in patients (pts) with arterial hypertension (HTN) and it is considered a risk factor for atrial fibrillation or cerebral ischaemic events. The age of the pts as well as the left ventricular (LV) hypertrophy are associated with the development of LAD, while the contribution of coronary artery disease (CAD) is a frequent and independent factor.

Methods:

100 pts with chronic HTN, who underwent cardiac catheterization for the evaluation of angina, were studied. CAD was detected in 62 pts. From the echo-doppler study, LAD (>38mm in female and >42 mm in male pts) was present in 35 pts. LV structure as well as LV systolic and diastolic function was also evaluated.

Results:

Pts with LAD were relatively older (66 vs 60-years-old, p=0,004), without any statistically significant difference in the indices of LV structure or systolic function (p=NS). However, they had higher end-diastolic transmitral velocities (A: 85 vs 67cm/sec, p=0,0005), lower E/A ratios (0,71 vs 0,84, p=0,04), increased deceleration, isovolumic relaxation as well as whole relaxation times (261 vs 230msec, p=0,03, 131 vs 118msec, p=0,002 and 392 vs 348msec, p=0,003 respectively). In the subgroup of pts with CAD, the pts with LAD also had increased A-wave velocities (83 vs 66 cm/sec, p= 0,01), increased deceleration, isovolumic relaxation as well as whole relaxation times (272 vs 237msec, p=0,05, 138 vs 123msec, p=0,03 and 410 vs 360msec, p=0,007 respectively). In pts with HTN without CAD, there was a difference in the age of the pts (66 vs 58 years, p=0,03) and the A-wave velocity (88 vs 68 cm/sec, p=0,01). The LAD was significantly correlated (p<0,00001) with the age, LV mass index, the A-wave velocity and the isovolumic relaxation time (r= 0.36, 0.24, 0.34, 0.30). In the multivariate analysis (r=0.59, F=12.7, p<0.00001), the independently predictive values of LAD were the age (p=0.01), the LV mass (p=0.001), the A-wave (p=0.001) and the isovolumic relaxation time (0.0001).

Conclusions:

It is concluded that in pts with HTN, LAD is mostly correlated with the LV diastolic function, especially in the presence of angiographically documented CAD.

left atrium dilatation, ventricular diastolic function, coronary artery disease