摘要
Background: Arterial hypertension determines distinct adaptive left ven tricula r geometric responses, which may differently affect left ventricular function an d left atrial performance. Objectives: In this study, the effect of left ventr ic ular geometry on left atrial size and function, and the relationship between lef t atrial size and left ventricular mass were assessed in 336 patients with syste mic arterial hypertension who had undergone Doppler echocardiography. Methods an d results: Patients were classified into concentric (110 patients with concentri c left ventricular geometry defined as relative wall thickness ≥0.44) and eccen tric groups (226 patients with relative wall thickness< 0.44). Comparison to the latter, the former had greater left atrial size, left atrial ejection force, le ft ventricular mass and lower left ventricular midwall fractional shortening. Le ft ventricular concentric, rather than eccentric, geometry emerged by multivaria te analysis as a factor independently associated with the highest degree of left atrial ejection force. Left atrial size was positively related to left ventricu lar mass in the whole population (r=0.65, SEE=6 ml, P < 0.00001). This relations hip was maintained in the subgroups with concentric(r=0.65, SEE =6 ml, P < 0.000 01) or eccentric geometry (r=0.59,SEE= 6 ml, P < 0.00001). Conclusions: Our resu lts indicate that the relationship of left ventricular geometry to both left atr ial size and ejection force in hypertensive patients is relevant. Concentric lef t ventricular geometry is associated with greater left atrial size and ejection force than eccentric geometry, suggesting that increased left ventricular stiffn ess has a greater effect in stimulating left atrial performance than left ventri cular endsystolic stress. The degree of left atrial enlargement similarly depend s on left ventricularmass in patients with concentric and eccentric geometry.
Background: Arterial hypertension determines distinct adaptive left ven tricula r geometric responses, which may differently affect left ventricular function an d left atrial performance. Objectives: In this study, the effect of left ventr ic ular geometry on left atrial size and function, and the relationship between lef t atrial size and left ventricular mass were assessed in 336 patients with syste mic arterial hypertension who had undergone Doppler echocardiography. Methods an d results: Patients were classified into concentric (110 patients with concentri c left ventricular geometry defined as relative wall thickness ≥0.44) and eccen tric groups (226 patients with relative wall thickness< 0.44). Comparison to the latter, the former had greater left atrial size, left atrial ejection force, le ft ventricular mass and lower left ventricular midwall fractional shortening. Le ft ventricular concentric, rather than eccentric, geometry emerged by multivaria te analysis as a factor independently associated with the highest degree of left atrial ejection force. Left atrial size was positively related to left ventricu lar mass in the whole population (r=0.65, SEE=6 ml, P < 0.00001). This relations hip was maintained in the subgroups with concentric(r=0.65, SEE =6 ml, P < 0.000 01) or eccentric geometry (r=0.59,SEE= 6 ml, P < 0.00001). Conclusions: Our resu lts indicate that the relationship of left ventricular geometry to both left atr ial size and ejection force in hypertensive patients is relevant. Concentric lef t ventricular geometry is associated with greater left atrial size and ejection force than eccentric geometry, suggesting that increased left ventricular stiffn ess has a greater effect in stimulating left atrial performance than left ventri cular endsystolic stress. The degree of left atrial enlargement similarly depend s on left ventricularmass in patients with concentric and eccentric geometry.
