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INVESTIGATION OF THE RELATIONSHIP BETWEEN LEFT ATRIAL STRAIN AND STIFFNESS AND LEFT VENTRICULAR DIASTOLIC FUNCTION ASSESSED BY ECHOCARDIOGRAPHY IN PATIENTS WITH ESSENTIAL HYPERTENSION
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Abstract
Objective: To investigate the relationship between left atrial strain and stiffness with left ventricular diastolic function in patients with primary hypertension. Methods: This study included 103 patients diagnosed with primary hypertension. The control group consisted of 31 healthy individuals matched for age. All participants underwent standardized transthoracic echocardiography. Based on the number of abnormal diastolic function parameters as recommended in the 2016 ASE/EACVI Guidelines for the Evaluation of Left Ventricular Diastolic Function — including: average E/e’ > 14; septal e’ velocity < 7 cm/s or lateral e’ < 10 cm/s; peak tricuspid regurgitation velocity > 2.8 m/s; and left atrial volume index (LAVI) > 34 ml/m² — the hypertensive patients were classified into three groups: Group I (0 abnormal parameters), Group II (1 parameter), and Group III (2 parameters). Results: In the hypertensive group, reservoir strain LASr 4-chamber was 35.9 ± 10.6%, LASr 2-chamber was 34.0 ± 9.3%; conduit strain LAScd 4-chamber was 16.7 ± 8.1%, LAScd 2-chamber was 14.7 ± 6.5%; booster strain LASct 4-chamber was 19.1 ± 8.0%, LASct 2-chamber was 19.5 ± 7.3%; and left atrial stiffness index (LASI) was 0.24 ± 0.1. Compared with the control group, reservoir and conduit strains were significantly reduced, and LASI was significantly increased (p < 0.05), while booster strain showed no significant difference (p > 0.05). LASr showed moderate positive correlations with septal and lateral e’, and weak negative correlations with E/e’ and LAVI. Compared to Group I, LASr and LAScd were reduced, and LASI increased in Groups II and III (p < 0.05). Compared to Group II, LASr was lower and LASI was higher in Group III (p < 0.05). Conclusions: Left atrial reservoir and conduit strains were significantly reduced, while stiffness index was significantly increased in hypertensive patients compared to healthy age-matched controls. In hypertensive patients, LASr showed a positive correlation with septal and lateral e’, and a negative correlation with E/e’ and LAVI. LASr decreased and LASI increased with the number of abnormal diastolic function parameters.
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Keywords
primary hypertension, left atrial strain, left atrial stiffness, left ventricular diastolic function.
References
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