Beta‐Blocker Use Is Associated With Impaired Left Atrial Function in Hypertension

Sardana, Mayank; Syed, Amer Ahmed; Hashmath, Zeba; Phan, Timothy S.; Koppula, Maheswara R; Kewan, Uzma; Ahmed, Zoubair; Chandamuri, Ravikantha; Varakantam, Swapna; Shah, Ejaz; Gorz, Ryan; Akers, Scott; Chirinos, Julio A.

doi:10.1161/jaha.116.005163

Cited by 25 publications

(16 citation statements)

References 30 publications

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“…A previous study demonstrated that beta blockers had no effect on the LA functions in patients with heart failure . Another study showed that beta blocker use was associated with a decreased LA function in hypertensive patients . The differences in the results of our studies can be explained by the facts that we excluded patients with hypertension and recruited patients who were about 3 decades younger.…”

Section: Discussionmentioning

confidence: 74%

“…34 Another study showed that beta blocker use was associated with a decreased LA function in hypertensive patients. 35 The differences in the results of our studies can be explained by the facts that we excluded patients with hypertension and recruited patients who were about 3 decades younger. Also, in contrast with the patients in that study, our patients used the lowest dose of beta blockers and did not take other drugs.…”

Section: Discussionmentioning

confidence: 84%

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Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Haji-Zeinali

Iri

Hosseinsabet

2018

J of Ultrasound Medicine

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Objectives The available literature lacks data on the comparison of the functions of the right atrium (RA) and left atrium (LA) between surgical atrial septal defect (ASD) closure and percutaneous device ASD closure at follow‐up durations of longer than 1 year. We sought to evaluate the RA and LA functions in patients who underwent surgical or device ASD closure between 1 and 5 years postprocedurally. Methods The study population included 30 patients who underwent device ASD closure and 30 who underwent surgical ASD closure, who were matched for the procedural time, age, and sex, in addition to 30 control participants. The RA and LA functions were evaluated with 2‐dimensional speckle‐tracking echocardiography. Results The LA systolic and early diastolic strain and strain rate values and the RA early diastolic strain rate in the device closure group were more likely to be abnormal than in the control group. The RA systolic and late diastolic strain and strain rate values, the RA early diastolic strain rate, and the LA early diastolic strain in the surgical closure group were more likely to be abnormal than in the control group. The RA systolic strain and strain rate in the surgical closure group were more likely to be abnormal than in the device closure group. Conclusions The LA reservoir and conduit functions and the RA contraction function in the patients who underwent device ASD closure and all of the RA functions and the LA conduit function in the patients who underwent surgical ASD closure were more likely to be abnormal than those in the control participants. The RA reservoir function in the surgical closure group was more likely to be abnormal than that in the device closure group.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 84%

Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Haji-Zeinali

Iri

Hosseinsabet

2018

J of Ultrasound Medicine

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“…15 LA analyses were performed using cvi42 image analysis software (Circle Cardiovascular Imaging Inc., Calgary, Canada). LA endocardial borders were manually traced in apical 2- and 4-chamber views using LV end-diastole as the point of reference.…”

Section: Methodsmentioning

confidence: 99%

Late Systolic Myocardial Loading Is Associated With Left Atrial Dysfunction in Hypertension

Chirinos

Phan

Syed

et al. 2017

Circ: Cardiovascular Imaging

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Background Late systolic load has been shown to cause diastolic dysfunction in animal models. Whereas the systolic loading sequence of the ventricular myocardium likely affects its coupling with the left atrium (LA), this issue has not been investigated in humans. We aimed to assess the relationship between the myocardial loading sequence and LA function in human hypertension. Methods and Results We studied 260 subjects with hypertension and 19 normotensive age- and sex-matched controls. Time-resolved central pressure and LV geometry were measured with carotid tonometry and cardiac MRI, respectively, for computation of time-resolved ejection-phase myocardial wall stress (MWS). The ratio of late/early ejection-phase MWS time-integrals was computed as an index of late systolic myocardial load. Atrial mechanics were measured with cine-SSFP MRI using feature-tracking algorithms. Compared to normotensive controls, hypertensive participants demonstrated increased late/early ejection-phase MWS and reduced LA function. Greater levels of late/early ejection-phase MWS were associated with reduced LA conduit, reservoir and booster pump LA function. In models that included early and late ejection-phase MWS as independent correlates of LA function, late-systolic MWS was associated with lower, whereas early-systolic MWS was associated with greater LA function, indicating an effect of the relative loading sequence (late vs. early MWS) on LA function. These relationships persisted after adjustment for multiple potential confounders. Conclusions A myocardial loading sequence characterized by prominent late systolic MWS was independently associated with atrial dysfunction. In the context of available experimental data, our findings support the deleterious effects on late systolic loading on ventricular-atrial coupling.

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“…Возможно, подобное различие в проаритмических и прогностических эффектах атенолола и лозартана связано с неодинаковым влиянием препаратов на ремоделирование ЛП [66], о чем, кроме того, свидетельствуют опубликованные в этом году результаты исследования Sardana и соавт. [67], в котором было показано, что у пациентов с АГ прием ББ по сравнению с другими антигипертензивными препаратами ассоциировался с худшей функциональной сохранностью ЛП. Вместе с тем поперечный дизайн исследования не позволяет оценить причинно-следственный характер связи между используемым препаратом и ремоделированием ЛП.…”

Section: центральное давление и диастолическая дисфункция левого желуunclassified

Atrial Fibrillation and Arterial Hypertension: Gender Differences of Ventriculoatrial Remodeling With Preserved Ejection Fraction

Кобалава

Kokhan

Kiyakbaev

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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1 Российский университет дружбы народов Россия, 117198, Москва, ул. Миклухо-Маклая, 6 2 Московский государственный университет им. М.В. Ломоносова Россия, 199991, Москва, ул. Ленинские Горы, 1 На сегодняшний день имеется достаточное количество данных, подтверждающих существование гендерных особенностей эпидемиологии, патогенеза и прогностического значения фибрилляции предсердий (ФП). Структурная и функциональная перестройка левого предсердия, являющаяся главным субстратом возникновения и поддержания ФП, может быть более выражена у женщин, причиной чему, вероятно, являются свойственные им особенности нарушения диастолической функции миокарда левого желудочка, ремоделирование которого находится в тесной связи с параметрами давления в аорте. Гендерные различия центрального контура пульсовой волны были обнаружены во многих исследованиях, однако прогностическое значение этих параметров, а также их связь с ремоделированием левого предсердия нуждаются в дополнительном изучении. Текущие рекомендации по ведению больных с ФП уравнивают стратегии контроля ритма и частоты сокращений желудочков. В исследовании RACE выяснилось, что если среди мужчин исходы при обеих стратегиях не отличались, то у женщин рандомизация в группу контроля ритма достоверно повышала риск наступления комбинированной конечной точки, включившей сердечно-сосудистую смерть, развитие хронической сердечной недостаточности, тромбоэмболические осложнения, тяжелые побочные эффекты антиаритмической терапии. По-видимому, в определенных ситуациях у женщин с рецидивирующей ФП стратегию контроля частоты желудочковых сокращений можно рассматривать даже как более предпочтительную. Существующую терапию ФП сложно назвать оптимальной, в связи с чем одним из путей ее усовершенствования может быть учет гендерных особенностей предсердно-желудочково-артериального взаимодействия. Для подтверждения этого предположения необходимо проведение крупных хорошо организованных проспективных исследований. Ключевые слова: фибрилляция предсердий, ремоделирование левого предсердия, диастолическая дисфункция, центральное давление. Для цитирования: Кобалава Ж.Д., Кохан Е.В., Киякбаев Г.К., Шаваров А.А. Фибрилляция предсердий и артериальная гипертония: гендерные особенности желудочково-предсердного ремоделирования при сохраненной фракции выброса левого желудочка. Рациональная фармакотерапия в кардиологии 2017;13(4):541-549. DOI: http://dx.Today there is enough data on gender differences in regard to epidemiology, pathogenesis and prognostic value of atrial fibrillation (AF). Left atrial structural and functional changes associated with development and persistence of AF can be more significant for women than for men. Explanation for it can be provided by a higher prevalence of left ventricular diastolic dysfunction in women, which is strongly related with central aortic pressures. Many studies have shown gender differences of central pulse wave contour; however further investigations of their prognostic power and relationship with left atrial remodeling are needed. According to current guide...

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Beta‐Blocker Use Is Associated With Impaired Left Atrial Function in Hypertension

Cited by 25 publications

References 30 publications

Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Late Systolic Myocardial Loading Is Associated With Left Atrial Dysfunction in Hypertension

Atrial Fibrillation and Arterial Hypertension: Gender Differences of Ventriculoatrial Remodeling With Preserved Ejection Fraction

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