Disturbed Left Atrial Function is Associated with Paroxysmal Atrial Fibrillation in Hypertension

Abstract

BackgroundHypertension is the most prevalent and modifiable risk factor for atrial fibrillation. The pressure overload in the left atrium induces pathophysiological changes leading to alterations in contractile function and electrical properties. ObjectiveIn this study our aim was to assess left atrial function in hypertensive patients to determine the association between left atrial function with paroxysmal atrial fibrillation (PAF). MethodWe studied 57 hypertensive patients (age: 53±4 years; left ventricular ejection fraction: 76±6.7%), including 30 consecutive patients with PAF and 30 age-matched control subjects. Left atrial (LA) volumes were measured using the modified Simpson's biplane method. Three types of LA volume were determined: maximal LA(LAVmax), preatrial contraction LA(LAVpreA) and minimal LA volume(LAVmin). LA emptying functions were calculated. LA total emptying volume = LAVmax−LAVmin and the LA total EF = (LAVmax-LAVmin )/LAVmax, LA passive emptying volume = LAVmax− LAVpreA and the LA passive EF = (LAVmax-LAVpreA)/LAVmax, LA active emptying volume = LAVpreA−LAVmin and LA active EF = (LAVpreA-LAVmin )/LAVpreA. ResultsThe hypertensive period is longer in hypertensive group with PAF. LAVmax significantly increased in hypertensive group with PAF when compared to hypertensive group without PAF (p=0.010). LAAEF was significantly decreased in hypertensive group with PAF as compared to hypertensive group without PAF (p=0.020). A' was decreased in the hypertensive group with PAF when compared to those without PAF (p = 0.044).ConclusionIncreased LA volume and impaired LA active emptying function was associated with PAF in untreated hypertensive patients. Longer hypertensive period is associated with PAF.

The relationship of arrhythmias with structural and functional heart changes according to the echocardiography data in the adult population of the Arctic

“…Нормальное старение связано с по-явлением фиброзных изменений в миокарде, дилата-ции ЛП, гипертрофии ЛЖ и диастолической дисфунк-ции ЛЖ [7,8]. У пациентов с заболеваниями сердечно-сосудистой системы часто наблюдаются аритмии, структурные и функциональные изменения сердца [4,[9][10][11].…”

“…Диасто-лическая дисфункция ЛЖ ведет к повышению давле-ния в легочных венах и левом предсердии, увеличению размеров ЛП. Дилатация ЛП способствует развитию аритмий в связи с увеличением площади для re-entry, развитием фиброза и появлением аритмогенного суб-страта [7,8]. Установлена связь между дилатацией ле-вого предсердия и ФП [12,13].…”

“…Значимых взаимосвязей между гипертро-фией ЛЖ и ФП не выявлено, что может быть объясне-но разницей в возрастном составе участников (нами об-следовались не только пожилые люди, но и лица более молодого возраста). В литературе имеются сведения о связи между диастолической дисфункцией ЛЖ и не-клапанной ФП [8,13], что согласуется с результатами проведенного исследования. Кроме того, нами уста-новлена значимая взаимосвязь между нарушением диа-столической функции ЛЖ и ЖЭ.…”

Regulation of inward rectifier potassium current ionic channel remodeling by AT1‐Calcineurin‐NFAT signaling pathway in stretch‐induced hypertrophic atrial myocytes

“…During the initiation and development of atrial fibrillation (AF), atrial remodeling occurs constantly because of increasing atrial pressure or volume load, which is induced by underlying disease and AF itself (Chinali et al, ; Pritchett et al, ; Gottdiener et al, ; Tenekecioglu et al, ; Ágoston et al, ; Kishima et al, , ; Morris et al, ). The subsequent changes in atrial electrophysiological properties are termed atrial electrical remodeling (AER).…”

<b>Mensuração do Tempo de Condução Atrial Total por meio da ecocardiografia tecidual em cães normais e em cães com Valvopatia Mitral Mixomatosa</b>

“…Além disso, em seres humanos casos de disfunção diastólica frequentemente têm origem no miocárdio ventricular, de modo que o estudo da função atrial reflete a sobrecarga de pressão atrial secundária à alteração de relaxamento ventricular (TENEKECIOGLU et al, 2014). A avaliação da disfunção diastólica no contexto da valvopatia mitral em cães é complexa e discutível, pois reflete uma combinação das condições de relaxamento do miocárdio, a distensibilidade da câmara ventricular, o volume regurgitante, a função atrial e a pressão nas veias pulmonares (BORGARELLI et al, 2004).…”