Evaluation Of Left Atrial Function In Patients With Hypertension By Acoustic Quantification Technique

Objective:To evaluate left atrial(LA)function between various left ventricular (LV) geometry in patients with primary hypertension by acoustic quantification (AQ) technique and to explore new methods and quantitive index for assessing LA function.Methods:The study included 29 healthy participants as the control group and 116 patients with primary hypertension. The patients were divided into groups of normal geometric LV(LN, n=25), concentric remodeling (CR, n=38), concentric hypertrophy (CH, n=33) and eccentric hypertrophy (EH, n=20). End-diastole volume (EDV), end-systolic volume(ESV), onset atrial emptying volume(OAEV), left atrial reservoir volume (LARV), left atrial total emptying fraction (LATEF), peak filling rate(PFR), left rapid emptying volume (LREV), left rapid emptying fraction(LREF), peak rapid emptying rate (PRER), left atrial emptying volume(LAEV), left atrial ejection fraction (LAEF) and peak atrial emptying rate(PAER) were measured by AQ technique. Make a analysis of correlation factor.Results:Compared with the control subjects, there was no difference in heart rate and age; Systolic pressure ,diastolic pressure and left ventricular mass index(LVMI)increased significantly among different hypertensive groups(P<0.05～0.001). Compared with the LN group, systolic pressure, diastolic pressure and LVMI in CH group (P<0.05～0.001). Compared with the LN and CH group, LVMI increased in EH group ( P<0.001). Compared with the LN,CR and CH group, left ventricular ejection fraction(LVFF) decreased in EH group ( P<0.001).Compared with the control subjects, LAD significantly enlarged in different hypertensive groups( P<0.001), especially in EH group.Compared with the control subjects, PFR increased significantly in CH and EH group(P<0.01～0.05). Compared with the CH group, LATEF decreased significantly in EH group(P<0.05) . The rise in LARV was a trend, but the results among different hypertensive groups had no statistical significance. Compared with the control subjects, LREF decreased significantly in EH group(P<0.001), there was significant difference between EH group and any other group(P<0.01). Compared with the control subjects,LAEV and PAER increased significantly(P<0.01～0.001);LAEF increased significantly in CR and CH group(P<0.05). Compared with the CR and CH group, LAEF decreased, but the difference had no statistical significance.LARV positively correlated to LAEV, LREV, PRER and PAER ( r=0.72,0.77,0.72,0.65, P<0.01). LREF negatively correlated to OAEV(r=-0.52, P<0.01); LAEF positively correlated to LAEV(r=0.69, P<0.01); ESV positively correlated to PAER and PRER(r=0.51,0.53, P<0.01).Conclusions:Left atrial function can change in the earlier stage before left ventricular hypertrophy. In hypertensive patients, left atrial booster pump function and reservoir function increase to compensate for impaired left ventricular diastolic function while conduit function decreases, especially in CH and EH group, but decrease in EH group. AQ technique may be used as a method to quantify left atrial function in patients with primary hypertension.