4.6 RELATIONSHIP OF CAROTID ARTERIAL FUNCTIONAL AND STRUCTURAL CHANGES TO LEFT ATRIAL VOLUME INUNTREATED HYPERTENSION

Abstract

The contribution of arterial functional and structural changes to left ventricular (LV) diastolic dysfunction has been the area of latest research. There are some studies on the relationship of arterial stiffness (a.s.) and left atrial (LA) remodeling as a marker of diastolic burden. Little is known on the association of arterial structural changes and LA remodeling in hypertension (H). The aim of this study was to examine the relationship of carotid a.s. and intimamedia thickness (IMT) to LA volume in subjects with H. The study included 245 previously untreated hypertensives (166 women and 79 men, mean age 53.7 ± 11.8 years). Each patient was subjected to echocardiography with measurement of LA volume, evaluation of left ventricular hypertrophy (LVH) and LV systolic/diastolic function indices, integrated assessment of carotid IMT and echotracking of a.s. and wave reflection parameters. Results: The following parameters were identified as independent determinants of indexed LA volume on multivariate regression analysis: diastolic blood pressure (beta = −0.229, p < 0.001), left ventricular mass index (LVMI; beta = 0.258, p < 0.001), E/e′ index (ratio of early mitral flow wave velocity - E to early diastolic mitral annular velocity-e′; beta = 0.266, p = 0.001), augmentation index (AI; beta = 0.143, p = 0.008) and bodymass index (BMI; beta = 0.132, p = 0.017). No correlations between indexed LA volume and IMT were found. Conclusion: There is a significant relationship of carotid arterial stiffness but not intima-media thickness to LA volume in patients with untreated hypertension.