Document Detail

Relationship between left ventricular geometry and left atrial size and function in patients with systemic hypertension.
MedLine Citation:
PMID:  15257183     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Arterial hypertension determines distinct adaptive left ventricular geometric responses, which may differently affect left ventricular function and left atrial performance. OBJECTIVES: In this study, the effect of left ventricular geometry on left atrial size and function, and the relationship between left atrial size and left ventricular mass were assessed in 336 patients with systemic arterial hypertension who had undergone Doppler echocardiography. METHODS AND RESULTS: Patients were classified into concentric (110 patients with concentric left ventricular geometry defined as relative wall thickness > or = 0.44) and eccentric groups (226 patients with relative wall thickness < 0.44). Comparison to the latter, the former had greater left atrial size, left atrial ejection force, left ventricular mass and lower left ventricular midwall fractional shortening. Left ventricular concentric, rather than eccentric, geometry emerged by multivariate analysis as a factor independently associated with the highest degree of left atrial ejection force. Left atrial size was positively related to left ventricular mass in the whole population (r = 0.65, SEE = 6 ml, P < 0.00001). This relationship was maintained in the subgroups with concentric (r = 0.65, SEE = 6 ml, P < 0.00001) or eccentric geometry (r = 0.59, SEE = 6 ml, P < 0.00001). CONCLUSIONS: Our results indicate that the relationship of left ventricular geometry to both left atrial size and ejection force in hypertensive patients is relevant. Concentric left ventricular geometry is associated with greater left atrial size and ejection force than eccentric geometry, suggesting that increased left ventricular stiffness has a greater effect in stimulating left atrial performance than left ventricular end-systolic stress. The degree of left atrial enlargement similarly depends on left ventricular mass in patients with concentric and eccentric geometry.
Giovanni Cioffi; Gian Francesco Mureddu; Carlo Stefenelli; Giovanni de Simone
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  22     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-16     Completed Date:  2005-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1589-96     Citation Subset:  IM    
Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
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MeSH Terms
Age Factors
Echocardiography, Doppler
Heart Atria / pathology,  physiopathology,  ultrasonography
Hypertension / pathology*,  physiopathology*
Hypertrophy, Left Ventricular / pathology*,  physiopathology*,  ultrasonography
Middle Aged
Sex Factors
Ventricular Dysfunction, Left / pathology,  physiopathology,  ultrasonography
Comment In:
J Hypertens. 2004 Aug;22(8):1473-4   [PMID:  15257167 ]

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