Effect of Blood Pressure Control on Left Atrial Function Assessed by 2D Echocardiography in Newly Diagnosed Patients with Systemic Hypertension

Abstract

Background and Aim: The objective of this study was to investigate the impact of appropriate blood pressure (BP) control on left atrial (LA) function in recently diagnosed individuals with systemic hypertension (HTN), as assessed by two-dimensional (2D) speckle echocardiography and electrocardiography. Materials and Methods: The study included 50 patients who were recently diagnosed with systemic arterial HTN and sought medical attention at Ain Shams University Hospital. The patients’ demographic information, risk factors, general and local examinations, 12-lead electrocardiograms (ECG), 2D speckle tracking ECGs, and laboratory measurements were evaluated. Following six months of appropriate BP control in accordance with Joint National Committee 10, the patients were followed up. Results: Peak atrial longitudinal strain (PALS) increased in the current study, with a mean change of 35.04±4.33 to 38.92±5.52 and a P-value <0. 001. The mean peak atrial contraction, picture archiving and communication system (PACS) strain, increased from 17.38±4.67 to 20.46±4.39, with a P-value of less than 0.001. The mitral peak early (E) and septal mitral annular velocities (e’) and their average E/e’ decreased with a change in the mean from 8.8±0.93 to 7.8±1.16, with a P-value of less than 0.001. The mean LA stiffness index (LASI) decreased from 0.24±0.04 to 0.2±0.03, with a P-value less than 0.001. The ECG follow-up showed no discernible change in the P-wave’s duration or amplitude with P-values of 0.135 and 0.785, respectively. Conclusion: The results of this study showed that patients with HTN may benefit from speckle tracking imaging to identify mild impairment of LA function. PALS, PACS, E/e’, and LASI improve in hypertensive patients when BP is well controlled. Additional studies are necessary to enhance the comprehension of LA function assessed via speckle tracking echocardiography, particularly in predicting atrial fibrillation and evaluating the risk of heart failure.

Keywords

• hypertension
• left atrium strain
• left atrium stiffness index
• intra-atrial conduction delay