Strain Echocardiographic Assessment of Left Atrial Function in Mild Hypertension

  • Dr Michiko Ichihara, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Dr Sayuki Kobayashi, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Dr Hiroko Zenri, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Dr Yoshihiko Sakai, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Dr Kan Takayanagi, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Mr Shinji Sasaki, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Mr Yoshiaki Konuma, Department of Cardiology and Department of Clinical Labolatory, Japan
  • Dr Kousuke Haruki, Department of Cardiology and Department of Clinical Labolatory, Japan

    • Purpose: The present study estimates the left atrial function in mild hypertension without left ventricular hypertrophy or an enlarged left atrium by 2D tracking echocardiography.
    Methods: We compared 20 patients (mean age, 55 ± 8 years) with mild hypertension unaccompanied by left ventricular hypertrophy or left atrial enlargement and 20 control individuals (mean age, 52 ± 6 years) with no significant heart rate anomalies using 2D tracking echocardiography.
    Apical four-chamber views were recorded by two-dimensional echocardiography using the Artida cardiac ultrasound system (Toshiba, Tokyo, Japan).
    We manually traced the left atrium and obtained the strain curve of the inter-atrial septum (IAS) and the lateral wall of the left atrium. The intervals between the beginning of the Q wave in the ECG and the peak strain of IAS and the lateral wall of left atrium (Q-p time) were compared between the two groups.
    Results:
    1. The Q-p time of the lateral wall of the left atrium was longer than that of the IAS in patients with mild hypertension (491 ± 59 vs. 446 ± 83 msec, p < 0.05). However, we did not recognize a difference between the lateral wall and the IAS in controls.
    2. The Q-p time of the lateral wall of the left atrium was also longer in patients with mild hypertension than in controls (491 ± 59 vs. 394 ± 51 msec, p = 0.0004).
    Conclusion: The lateral wall of the left atrium seems to be influenced sooner than the inter-atrial septum under pressure overload.