Marijana Tadic1,2, Cesare Cuspidi3, Vesna Kocijancic1, Vera Celic1,2, Vladan Vukomanovic1. 1. Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Belgrade, Serbia. 2. Faculty of Medicine, Medical School, Belgrade University, Belgrade, Serbia. 3. Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy.
Abstract
OBJECTIVE: The aim of the study was to evaluate right atrial (RA) phasic function in hypertensive patients with different left ventricular (LV) geometric patterns by using two-dimensional (2DE) and three-dimensional (3DE) echocardiography. METHODS: This cross-sectional study involved 177 hypertensive patients who underwent 2DE and 3DE examination. The updated criteria of LV geometry that included LV mass index, LV end-diastolic diameter, and relative wall thickness were applied. Using this classification, patients were separated into six groups: normal geometry, concentric remodeling, eccentric nondilated LV hypertrophy (LVH), concentric LVH, dilated LVH, and concentric-dilated LVH. RESULTS: Two-dimensional echocardiography and 3DE RA volumes were significantly higher in concentric and dilated LVH than in other LV geometric types. RA reservoir function, estimated by total 2DE and 3DE RA emptying fraction (EF), was decreased in subjects with dilated LVH compared with normal geometric and concentric LV remodeling patterns. RA conduit function assessed with 2DE and 3DE RA passive EF, gradually reduced from normal LV geometry to dilated LVH. RA pump function was increased in patients with concentric and dilated LVH than in subjects with normal LV geometry and concentric remodeling. 2DE strain analysis confirmed these findings about RA phasic function. Concentric LVH and dilated LVH were associated with RA enlargement and dysfunction irrespectively of main demographic and clinical parameters. CONCLUSION: Left ventricular geometric patterns have significant impact on RA phasic function in hypertensive patients. Concentric and dilated LVH patterns have the most prominent negative effect on RA morphological and functional remodeling.
OBJECTIVE: The aim of the study was to evaluate right atrial (RA) phasic function in hypertensivepatients with different left ventricular (LV) geometric patterns by using two-dimensional (2DE) and three-dimensional (3DE) echocardiography. METHODS: This cross-sectional study involved 177 hypertensivepatients who underwent 2DE and 3DE examination. The updated criteria of LV geometry that included LV mass index, LV end-diastolic diameter, and relative wall thickness were applied. Using this classification, patients were separated into six groups: normal geometry, concentric remodeling, eccentric nondilated LV hypertrophy (LVH), concentric LVH, dilated LVH, and concentric-dilated LVH. RESULTS: Two-dimensional echocardiography and 3DE RA volumes were significantly higher in concentric and dilated LVH than in other LV geometric types. RA reservoir function, estimated by total 2DE and 3DE RA emptying fraction (EF), was decreased in subjects with dilated LVH compared with normal geometric and concentric LV remodeling patterns. RA conduit function assessed with 2DE and 3DE RA passive EF, gradually reduced from normal LV geometry to dilated LVH. RA pump function was increased in patients with concentric and dilated LVH than in subjects with normal LV geometry and concentric remodeling. 2DE strain analysis confirmed these findings about RA phasic function. Concentric LVH and dilated LVH were associated with RA enlargement and dysfunction irrespectively of main demographic and clinical parameters. CONCLUSION: Left ventricular geometric patterns have significant impact on RA phasic function in hypertensivepatients. Concentric and dilated LVH patterns have the most prominent negative effect on RA morphological and functional remodeling.
Authors: Andreas Schuster; Sören J Backhaus; Thomas Stiermaier; Jenny-Lou Navarra; Johannes Uhlig; Karl-Philipp Rommel; Alexander Koschalka; Johannes T Kowallick; Boris Bigalke; Shelby Kutty; Matthias Gutberlet; Gerd Hasenfuß; Holger Thiele; Ingo Eitel Journal: J Clin Med Date: 2020-01-12 Impact factor: 4.241