Relationship between the left atrial size and the degree of left ventricular hypertrophy in patients with systemic arterial hypertension

Background: Left atrial enlargement is frequently observed in many cardiac diseases. One of the main determinants of left atrial size is ventricular diastolic function. It has recently been suggested that left atrial volume might be the morphophysiologic expression of long-term modifications induced by diastolic function. Furthermore, left ventricular remodeling, such as it happens in hypertensive patients, is another important determinant of atrial volume.Objectives: The present study was specifically designed to identify the effects of systemic arterial hypertension on the left ventricular and left atrial function analyzed by 2D and M-mode echocardiographic images.Patients and methods: The study included two groups: Patient group included 30 hypertensive patients with age ranging from 35-70 years (51.5 ± 10.4); 11 males (36.7%) and 19 females (63.3%), were subjected to echocardiographic study including 2-dimensional and M-mode, at Echo Department, Faculty of Medicine, Zagazig University. Control group included 15 healthy volunteers with age ranging 35-70 years (51.2 ± 9.75); 7 males (46.7%) and 8 females (53.3%).Results: Statistically, there was no significant difference as regard the age. All patients in the study were subjected to full history taking with special emphasis on valvular heart diseases, congenital heart diseases, ischemic heart disease, medical therapy; especially antiarrhythmic drugs, thorough clinical examination with special emphasis on pulse rate, rhythm, systolic and diastolic blood pressure excluding patients on congestive heart failure, standard 12-lead ECG and echocardiographic examination including 2D and M-mode imaging. The study showed systemic arterial hypertension lead to impairment of left ventricular diastolic function due to increased afterload but also the changes of left ventricular geometry and structure producing left ventricular hypertrophy. Also, the left atrium involved in this process by structural abnormalities of the left atrial chamber as regarding by the echo imaging. There were positive correlation between LAD and degree of LVH represented by LVM and RWT also LAD positively correlate with LV internal dimension and DT and negatively correlate with E /A ratio.Conclusion: Left atrial size is increased in hypertension patients in relation to healthy subject and hypertensive patients left atrial size was stastically bigger in patients with left ventricular hypertrophy without significant difference between concentric and eccentric hypertrophy . LA size is related to LVM rather than type of LVH.