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BackgroundsThe extent of left atrial (LA) wall structural enlargement detected byechocardiography is correlated with atrial fibrillation (AF) andhypertension.The concomitant occurrence of AF, hypertension, and leftventricular (LV) dysfunction is not uncommon.We studied the effect of LAenlargement, a confounder of AF, hypertension, and LV dysfunction, on LVejection fraction (EF).
Methods
For the analysis, we identified and included 56 patients who underwenttransthoracic echocardiography.Patients were classified into 2 groups,where the first group was patients with hypertension alone, and the secondgroup was patients with hypertension and atrial fibrillation.Patients wereselected based on physical examination of hypertension, andelectrocardiography findings of atrial fibrillation.The exclusion criteriainclude patients with congestive heart failure, aortic and mitral valvedisease, cardiomyopathies, pericarditis, myocarditis, cardiac tumors,pulmonary hypertension, hyperthyroidism, and patients that underwentopen heart or thoracic surgery.Echocardiographic measurement includingLAD, LAV, LAVI, and LVEF were collected.Independent sample t-test wasused for comparing statistical significance between the two groups.
Differences were considered significant at a p value of ＜0.05.
Results
Comparison of the two groups showed that patients with hypertensionaccompanied by AF had significant higher value in LA size, and lowervalue in LVEF.In detail, mean of LA measurements show substantialdifference in LAD (32.69 ± 3.19 mm) vs.(38.83 ± 5.98 mm); LAV (50.59 ±16.41 mL) vs.(81.66 ± 37.56 mL); and LAVI (30.62 ± 10.13 mL/m2) vs.(48.10 ± 20.47 mL/m2), with LVEF (64.36 ± 2.69 ％) vs.(60.40 ± 6.13 ％).
ConclusionPatients with hypertension and AF appear to have more enlarged LA anddepressed LV function compare to patients with hypertension alone,suggesting that remodeling within the ventricular myocardium may betriggered and promoted by structural remodeling in the LA.