Novel parameter for assessment of left atrial size in patients with hypertension: ratio of left atrial volume to left ventricular volume

Abstract

Background: Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume (LAV/LVV) may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction.

Methods: Ninety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall (NW) and hypertrophic wall (HW) groups. The left atrial diameter (LAD), LAV, left atrial volume index (LAVi), LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E' velocity of lateral mitral annulus (E/E') was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function.

Results: The LAD, LAV, LAVi, LAV/LVV and E/E' in hypertensive groups were significantly higher than those in the normal group (P < 0.05 or 0.01), and those in the HW group were significantly higher than those in the NW group (P < 0.05 or 0.01). The E/E' had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E' and LAV/LVV was relatively higher than that between E/E' and LAD or LAVi.

Conclusion: LAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.