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Hypertension and renovascular disease
Strain rate evaluation of phasic atrial function in hypertension
  1. S Eshoo1,
  2. A C Boyd1,
  3. D L Ross1,
  4. T H Marwick2,
  5. L Thomas3
  1. 1
    University of Sydney, Westmead Hospital, Sydney, Australia
  2. 2
    University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
  3. 3
    Liverpool Hospital, Liverpool, NSW, Australia
  1. Dr S Eshoo, Department of Cardiology, Westmead Hospital, Darcy Road, Westmead, 2145 NSW, Australia; suzannee{at}westgate.wh.usyd.edu.au

Abstract

Background: Strain (SI) and strain rate (SR) measure regional myocardial deformation and may be a new technique to assess phasic atrial function.

Objective: To examine the feasibility of using SI and SR to evaluate phasic atrial function in patients with mild hypertension (HT).

Patients and methods: The study group comprised 54 patients with mild essential HT (29 women) and 80 age-matched normal controls (47 women). Standard two-dimensional and Doppler echocardiography was performed as well as Doppler tissue imaging. The following left atrial (LA) volumes were measured: (a) maximal LA volume or Volmax; (b) minimal LA volume or Volmin; (c) just before the “p” wave on ECG (Volp). Phasic LA volumes were also calculated. Systolic (S-Sr), early diastolic (E-Sr), late diastolic (A-Sr) strain rate and SI were measured.

Results: Despite no differences in indexed maximal LA volume with only mild increases in left ventricular mass in the HT cohort compared with normal subjects (mean (SD) 86 (18) g/m2 vs 67 (14) g/m2; p = 0.001), E-Sr was significantly lower in the HT cohort. There was a corresponding reduction in indexed conduit volume in the HT cohort compared with normal subjects (10.5 (7.5) ml/m2 vs 13.8 (6.1) ml/m2; p = 0.006). Global E-Sr showed modest negative correlations with LA Volmax and LA ejection fraction. No significant difference was present in S-Sr, A-Sr or global atrial strain between the normal and HT cohorts.

Conclusion: Mild HT results in a reduction in LA conduit volume, although maximal LA volume is unchanged. This is reflected by a reduction in E-Sr with preserved S-Sr and A-Sr.

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Footnotes

  • Funding: SE is a postgraduate medical scholar supported by a University of Sydney postgraduate award.

  • Competing interests: None.

  • Ethics approval: Ethics committee approval from Westmead Hospital Human Research Ethics Committee.

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