Association of Heart Rate with Left Ventricular and Left Atrial Functions in Hypertensive Patients with Normal Left Ventricular Ejection Fraction (A Speckle Tracking Study)

Abstract

Purpose The structure and functions of the left heart cavities have important prognostic value in heart diseases and heart rate control is among the important treatment goals. In this study, we investigated the effects of heart rate on left heart structure and functions in hypertension patients with normal left ventricular systolic function. Method One-hundred-fifty-three patients were included in the study. The patients were divided into two groups according to their heart rate(70 beats/min and below and above 70 beats/min). Left ventricular and atrial strain analyses were performed in echocardiographic evaluation. Results Patients with a resting heart rate of 70 or less were named group-1(64.2±19), patients with a resting heart rate above 70 were named group-2(79.1±6.8). Left atrial max volüm (60.8±15.5 vs 52.9±16.3 p:0.007), left atrial min volüm(28.8±9.5 vs 22.6±7.9 p < 0.001), left atrial emptying fraction%(52.8±8.5 vs 56.1±8.5 p:0.035), left atrial expansion index (1.19±0.44 vs 1.36±0.47 p:0.044), GLSReLA(-1.3±0.38 vs -1.5±0.61 p:0.031), GLS(-19.3±3 vs. -18.2±2.7 p:0.07) showed difference between group-1 and group-2, respectively. In the multivariable regression analysis, beta-bloker(OR:0.291, 95% CI 0.105–0.810, p:0.018), mean high diastolic blood pressure(OR:1.054, 95% CI 1.009–1.101, p:0.018), left atrial min volume( OR:0.870, 95% Cl 0.809–0.938, p < 0.001), Sm(OR:10.6, 95% CI 1.1–104, p:0.041), left atrial expansion index(OR:0.870, 95% CI 0.809–0.930, p < 0.033) were determined as independent predictors of high resting heart rate. Conclusions Heart rate control emerges as an important goal in patients with hypertension and preserved left ventricular systolic function. Mortality and morbidity can also be improved by the positive effect of heart rate control on GLS.