A novel echocardiographic marker in hypertensive patients: is diastolic dysfunction associated with atrial electromechanical abnormalities in hypertension?

Abstract

Atrial arrhythmias are common problems in hypertensive patients. Atrial electromechanical delay (AEMD) can be used to evaluate development of atrial arrhythmias. The authors aimed to assess inter- and intra-AEMD in hypertensive patients. The study population consisted of 200 medically treated hypertensive patients and 151 normotensive controls. Inter-AEMD and intra-left AEMD were measured from parameters of Doppler tissue imaging. There were 72 (36%) hypertensive patients with diastolic dysfunction, 128 (64%) patients without diastolic dysfunction, and 151 healthy controls. Inter-AEMD (59 ms [36-104 ms] vs 42 ms [36-68 ms] vs 46 ms [30-82 ms]) was significantly higher in hypertensive patients with diastolic dysfunction compared with patients without diastolic dysfunction and controls. Our data demonstrated that inter-AEMD is longer in hypertensive patients with diastolic dysfunction. It may be suggested that diastolic dysfunction is associated with atrial electromechanical abnormalities, which can be associated with atrial fibrillation in hypertension.

Figure 1

Distributions of inter‐atrial electromechanical delay (AEMD) in hypertensive patients with diastolic dysfunction and without diastolic dysfunction and control patients. Group 1 represents: hypertensive patients with diastolic dysfunction and group 2 represents hypertensive patients without diastolic dysfunction (group 1 vs group 2, P<.001; group 1 vs controls, P<.001; group 2 vs controls, P=not significant).

Figure 2

Distributions of intra‐left atrial electromechanical delay in hypertensive patients with diastolic dysfunction and without diastolic dysfunction and control patients. Group 1 represents hypertensive patients with diastolic dysfunction and group 2 represents hypertensive patients without diastolic dysfunction. (group 1 vs group 2, P=not significant; group 1 vs controls, P<.001; group 2 vs controls, P<.001).