Endothelial dysfunction, subclinical atherosclerosis and LDL cholesterol are the independent predictors of left atrial functions in hypertension

Int J Cardiovasc Imaging. 2020 Jan;36(1):69-77. doi: 10.1007/s10554-019-01699-2. Epub 2019 Oct 4.

Abstract

Left atrial function has an important role in determining optimal performance of the heart. Increase of left atrial dysfunction and volume are poor prognostic factors. In this study, we investigated independent determinants of left atrial function in non-diabetic patients with de novo hypertension. The study included 124 consecutive non-diabetic patients with de novo hypertension. Brachial artery flow-mediated dilatation, carotid intima-media thickness, transthoracic echocardiography, 24-h rhythm holter, and aortic stiffness measurements were recorded. In echocardiography, left atrial maximum (LAMaV) and minimum (LAMiV) volumes were calculated. Left atrium total emptying fraction (LATEF) and total emptying volume (LATEV) were divided into two groups according to the mean levels. Multivariate analysis was performed after correlation analysis for LATEV and LATEF mean levels. By logistic regression analysis, systolic blood pressure (OR 0.882, 95% CI 0.784-0.992, p = 0.036), percent of flow-mediated dilation (OR 0.747, 95% CI 0.595-0.938, p = 0.012), and presence of carotid plaque (OR 0.014, 95% CI 0.001-0.188, p = 0.001) were found as independent variables that determine LATEF. Age (OR 0.879, 95% CI 0.795-0.972, p = 0.012), smoking (OR 23.739, 95% CI 2.699-208.810, p = 0.004), left ventricular mass index (OR 1.052, 95% CI 1.012-1.094, p = 0.011), mitrale E-wave velocity (OR 1.108, 95% CI 1.031-1.191, p = 0.005) and LDL (low-density lipoprotein) cholesterol (OR 0.942, 95% CI 0.911-0.974, p = 0.001) were independent predictors of LATEV. In non-diabetic patients with de novo hypertension endothelial dysfunction, subclinical atherosclerosis and LDL cholesterol levels independently affect left atrial function.

Keywords: Dyslipidemia; Endothelial dysfunction; Left atrial function; Left atrial maximum volume; Left atrial minimum volume; Subclinical atherosclerosis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Atrial Function, Left*
  • Atrial Remodeling*
  • Biomarkers / blood
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiopathology*
  • Carotid Artery Diseases / blood
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / physiopathology*
  • Case-Control Studies
  • Cholesterol, LDL / blood*
  • Cross-Sectional Studies
  • Endothelium, Vascular / diagnostic imaging
  • Endothelium, Vascular / physiopathology*
  • Female
  • Heart Rate
  • Humans
  • Hypertension / blood
  • Hypertension / diagnostic imaging
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic
  • Prognosis
  • Prospective Studies
  • Vascular Stiffness
  • Vasodilation*

Substances

  • Biomarkers
  • Cholesterol, LDL