Left atrial enlargement in the early stage of hypertensive heart disease: a common but ignored condition

J Clin Hypertens (Greenwich). 2014 Mar;16(3):192-7. doi: 10.1111/jch.12282. Epub 2014 Feb 20.

Abstract

How to identify the early signs of hypertensive heart disease is the key to block or reverse the process of heart failure. The aim of this study was to evaluate the predictive value of left atrial (LA) enlargement in the early stage of hypertensive heart disease and to explore the correlations between LA enlargement and heart failure with normal ejection fraction (HFnEF), as well as the metabolic syndrome (MetS). Baseline clinical characteristics, biochemical indices, electrocardiographic and echocardiographic data were collected from 341 consecutive patients with essential hypertension. Among those patients, LA enlargement was more frequently presented than LV enlargement (57.2% vs 17.9%). Compared with patients without HFnEF, the prevalence of LA enlargement was higher in patients with HFnEF (82.9% vs 49.0%, P<.0001). From grade 2 to grade 3 hypertension, LA size was significantly larger in patients with MetS (P<.01) than those without. Multivariate linear regression analyses showed that age, body mass index, waist circumference, triglyceride level, and left ventricular diameter were independent predictors of LA enlargement. The simple measurement for identification of LA enlargement potentially allows early recognition of those patients at risk for heart failure, particularly among patients with MetS.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Female
  • Heart Atria / diagnostic imaging
  • Heart Atria / pathology*
  • Heart Diseases / epidemiology
  • Heart Diseases / etiology*
  • Heart Diseases / pathology*
  • Heart Failure / epidemiology
  • Heart Failure / physiopathology
  • Humans
  • Hypertension / complications*
  • Hypertrophy / diagnostic imaging
  • Hypertrophy / epidemiology
  • Hypertrophy / pathology
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / pathology
  • Incidence
  • Male
  • Metabolic Syndrome / complications
  • Middle Aged
  • Risk Factors
  • Stroke Volume / physiology
  • Ultrasonography