Quantitative assessment of left atrial functions by speckle tracking echocardiography in hypertensive patients with and without retinopathy

Abstract

Purpose The association between hypertensive retinopathy and left atrial (LA) impairment is unknown. Accordingly, it was aimed to investigate the possible relationship between hypertensive retinopathy and LA phasic functions by means of two‐dimensional speckle‐tracking echocardiography (2D‐STE). Methods A total of 124 hypertensive patients and 27 control subjects were included in the study. LA reservoir strain (LAS‐S), LA conduit strain (LAS‐E), and LA booster strain (LAS‐A) parameters were used to evaluate LA myocardial functions. Results Hypertensive patients (with and without retinopathy) displayed an obvious reduction in the LA reservoir strain (LAS‐S), and LA conduit strain (LAS‐E). Moreover, further impairment in LA reservoir and conduit strain was found in patients with hypertensive retinopathy than in the isolated hypertensive patients. There were no significant differences in LA booster strain (LAS‐A) among the three groups. Impaired LAS‐S (OR: 0.764, CI: 0.657–0.888, and p < 0.001), LAS‐E (OR: 0.754, CI: 0.634–0.897, and p = 0.001), and hypertension (HT) duration (OR: 2.345, CI: 1.568–3.507, and p < 0.001) were shown to be independent predictors of hypertensive retinopathy. Conclusion Impaired LA reservoir and conduit strain may be used to predict hypertensive patients at higher risk of developing hypertensive retinopathy, and to determine which patients should be followed more closely for hypertensive retinopathy.

Subclinical target organ damage as risk stratification parameter in hypertensive patients

“…In hypertensive patients, LA structural changes appears earlier than LV hypertrophy and LA enlargement is related to LV mass, rather than to the type of LV hypertrophy 4 . In the study published by celik et al, 2 indexed LV mass and LA volume were not statistically different in patients with retinopathy comparing with those without retinopathy. However, LA reservoir and conduit functions were statistically different.…”

“…LA reservoir and conduit functions, obtained from 2D speckle tracking echocardiography (STE)‐based strain, as markers of LA functional remodeling were independently related to retinopathy diagnosis. In addition, less than 32.21% could predicts retinopathy with 71.4% sensitivity and 69.1% specificity 2 . A cut‐off value of in predicting retinopathy was 16.92% with 73.2% sensitivity and 70.6% specificity 1 .…”

“…In the article entitled: “Quantitative Assessment of Left Atrial Functions by Speckle Tracking Echocardiography in Hypertensive Patients with and without Retinopathy” (manuscript JCU‐22‐161R1), 2 the authors aimed to determine “whether the degree of deterioration in the LA strain predicts the presence of retinopathy”. The eye is one of the target organ damaged in patients with HTN.…”

“…Subclinical target organ damage assessment in HTN implies the evaluation of the consequences on the heart (LV hypertrophy by electrocardiogram and echocardiography) and cardiovascular system (vessels, brain, kidney, eye) 2 as shown in Figure 1. Asymptomatic involvement of different organs in patients affected by HTN represents an independent determinant of cardiovascular risk 3,4 .…”

“…4 In hypertensive patients, LA structural changes appears earlier than LV hypertrophy and LA enlargement is related to LV mass, rather than to the type of LV hypertrophy. 4 In the study published by celik et al, 2 strain is able to detect subclinical dysfunction both, in LV and LA. 3,5 LA dilation could predict hypertensive target organ damage.…”