Published Online
on January 26, 2009

A more recent version of this article appeared on March 1, 2009

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Original Article

Impact of Mild Hypertension on Left Atrial Size and Function

Suzanne Eshoo^1,3; David L. Ross¹ and Liza Thomas²

¹ Westmead Hospital, University of Sydney, Australia;
² Liverpool Hospital, University of NSW, Australia

³ E-mail: suz2153{at}yahoo.com.au

Background—Left atrial (LA) enlargement has been documented to occur in moderate and severe hypertension (HT).

Methods and Results—112 mild HT patients were prospectively recruited and compared to 198 healthy volunteers. All recruits had a transthoracic echocardiogram (TTE). Maximum (Vol_max), minimum (Vol_min) and pre ‘p’ (Vol_p) LA biplane volumes were measured and LA passive, active emptying and conduit volumes were calculated at baseline and in a subgroup of patients after 12 months. After adjusting for age, gender and BMI, Vol_max and Vol_p and their indexed volumes were increased in the HT group. Active emptying volume and fraction were significantly increased in the HT group with no change in conduit and passive volumes. Subgroup analysis comparing hypertensives with normal/mildly increased left ventricular mass (LVM) (Group 1) to those with moderate/severely increased LVM (Group 2) at baseline demonstrated that Vol_max (62.8 ± 17.9 mL vs. 45.4 ± 13.7 mL; p < 0.001) was significantly increased in Group 2. Active emptying volume was also increased.

Conclusion—Even mild hypertension appears to be associated with a reduction in early diastolic filling. This results in augmented late LV diastolic filling due to active atrial contraction and may be the mechanism for the increase in LA size.

Key Words: diastole • echocardiography • hypertension • left atrium • phasic volumes

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Impact of Mild Hypertension on Left Atrial Size and Function

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