To Evaluate The Relationship Between Left Atrial Volume Index And Left Ventricular Diastolic Function In Patients With Hypertension

Objective:By researching the relationship between left atrial volume index (LAVI) and left ventricular diastolic function of essential hypertensive patients, we may provide a index to evaluate the left ventricular diastolic function in patients with hypertension.Methods:110 patients with essential hypertension and healthy control group of 30 patients(group 1) were enrolled in this research. All of them were detected by conventional echocardiography for the following parameters:the early diastolic peak velocity of mitral inflow (E), the late diastolic peak velocity of mitral inflow (A),the left atrial area in the apical four chamber view and two chamber view in left ventricular systolic period when left atrial volume was maximum(A1, A2), and the distance from the midpoint of mitral annulus to the top of left atrium (L1, L2) and so on. E/A and LAVI were also calculated. Pulsed-Wave Tissue Doppler Imaging (PW-TDI) was used to test the early and late diastolic peak velocity of mitral annulus myocardium (Em, Am),systolic peak velocity (Sm) and other parameters.Em/Am, E/Em were calculated then. According to the standards recommended by American Association of Echocardiography, the left ventricular diastolic dysfunction was classified as four degrees, so that the 110 patients with essential hypertension could be divided into four groups. They are:Group 2:normal diastolic function (11, E/Em≤8); Group 3:early diastolic dysfunction group (E/A<1, Em/Am<1,82, Em/Am<1, E/Em≥15).The LAVI between each group of patients with hypertension and the healthy control group (group1) were compared.Besides, the circulation of LAVI,conventional echocardiography parameters and PW-TDI index to judge left ventricular diastolic dysfUnction and pseudonormal was analyzed.Results:1.In the groups of patients with hypertension,the more severe of diastolic dysfunction had got, the lower of Em would be.The difference between the groups was significant (P<0.05).The more severe of diastolic dysfunction had got, the greater of E/Em would be. E/Em could be seen like this:group 5> group 4> group 3> group 2. The difference between groups was significant (P<0.05). The Em,E/Em of group 1 and group 2 had no significant difference(P>0.05).2. From the healthy control group to group2,group 3,group 4 and group 5, LAVI increased gradually, which could be discribed in this form: group 1 (18.95±5.74ml/m2)0.05).The AUC for LAVI, E/Em to identify left ventricular diastolic function in hypertensive patients with pseudonormal were 0.878,0.855.There were no significant difference between them (P>0.05).Conclusion:1. Left Atrial Volume Index is suggested to be a good index to assess left ventricular diastolic function in hypertensive patients.2.The larger left atrial volume index has got, the more severe of left ventricular diastolic dysfunction would be.3.LAVI reflect left ventricular diastolic dysfunction in hypertensive patients may be earlier than E/Em.4.Sm,BMI,LVMI and age are impact factors of LAVI.