doi: 10.1161/hy0302.105683
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(Hypertension. 2002;39:739.)
© 2002 American Heart Association, Inc.
Scientific Contributions |
Correlates of Left Atrial Size in Hypertensive Patients With Left Ventricular Hypertrophy
The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study
From Department of Heart Disease, Haukeland University Hospital (E.G.), Bergen, Norway; Department of Medicine, Helsinki University Central Hospital (L.O.), Helsinki, Finland; Department of Medicine, Weill Medical College of Cornell University (V.P., R.B.D.), New York, NY; Department of Medicine, Vestfold Central Hospital (J.E.O.), Tönsberg, Norway, Department of Medicine, Copenhagen County University Hospital (K.W.), Glostrup, Denmark; Department of Medicine, Skellefteaa Hospital and Umeaa University (K.B.), Skellefteaa, Sweden; and Department of Medicine, Sahlgrenska University Hospital-Östra (B.D.), Gothenburg, Sweden.
Correspondence to Eva Gerdts MD, PhD, Department of Heart Disease, Haukeland University Hospital, N-5021 Bergen, Norway. E-mail evgerdts{at}online.no
Left ventricular hypertrophy has been suggested to mediate the relation between hypertension and left atrial enlargement, with associated risks of atrial fibrillation and stroke. However, less is known about correlates of left atrial size in hypertensive patients with left ventricular hypertrophy. We assessed left atrial size by echocardiography in 941 hypertensive patients, age 55 to 80 (mean, 66) years, with electrocardiographic left ventricular hypertrophy at baseline in the Losartan Intervention For Endpoint reduction in hypertension study. Enlarged left atrial diameter (women, >3.8 cm; men, >4.2 cm) was present in 56% of women and 38% of men (P<0.01). Compared with the 512 patients with normal left atrial size, the 429 patients with enlarged left atrium more often had mitral regurgitation, atrial fibrillation, and echocardiographic left ventricular hypertrophy. They also had higher age, systolic blood pressure, pulse pressure, weight, body mass index, left ventricular internal chamber dimension, stroke volume, and mass and lower relative wall thickness and ejection fraction (all, P<0.05). In logistic regression analysis, left atrial enlargement was related to left ventricular hypertrophy and eccentric geometry; greater body mass index, systolic blood pressure, and age; female gender; mitral regurgitation; and atrial fibrillation (all, P<0.05). Thus, left atrial size in hypertensive patients with electrocardiographic left ventricular hypertrophy is influenced by gender, age, obesity, systolic blood pressure, and left ventricular geometry independently of left ventricular mass and presence of mitral regurgitation or atrial fibrillation.
Key Words: left atrial size • hypertrophy • age • body mass index
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