Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;58(4):1125-1136.
doi: 10.1002/jmri.28604. Epub 2023 Feb 2.

Incremental Effect of Mitral Regurgitation on Left Atrial Dysfunction and Atrioventricular Interaction in Hypertensive Patients by MRI

Si-Shi Tang  1   2 , Rui Shi  1 , Zhi-Gang Yang  1 , Jin Wang  1 , Chen-Yan Min  1 , Wei-Feng Yan  1 , Yi Zhang  1 , Yuan Li  1
Affiliations

Incremental Effect of Mitral Regurgitation on Left Atrial Dysfunction and Atrioventricular Interaction in Hypertensive Patients by MRI

Si-Shi Tang et al. J Magn Reson Imaging. 2023 Oct.

Abstract

Background: Mitral regurgitation may occur when hypertension causes left ventricular (LV) and left atrial (LA) remodeling. However, its role in LA function in hypertensive patients remains unclear.

Purpose: To explore how mitral regurgitation affects LA function in hypertension and to investigate atrioventricular interaction in hypertensive patients with mitral regurgitation.

Study type: Retrospective.

Population: A total of 193 hypertensive cases and 64 controls.

Field strength/sequence: A 3.0 T/balanced steady-state free precession.

Assessment: LA volume (LAV), LA strain (reservoir, conduit, and active), LA ejection fraction, and LV strain (global peak longitudinal [GLS], circumferential [GCS], and radial strain [GRS]) were evaluated and compared among groups. Regurgitant fraction (RF) was evaluated in regurgitation patients and used to subdivide patients into mild (RF: 0%-30%), moderate (RF: 30%-50%), and severe (RF: >50%) regurgitation categories.

Statistical tests: One-way analysis of variance, Spearman and Pearson's correlation coefficients (r), and multivariable linear regression analysis. A P value <0.05 was considered statistically significant.

Results: Hypertensive patients without mitral regurgitation showed significantly impaired LA reservoir and conduit functions and significantly decreased LV GLS but preserved pump function and LAV compared to controls (P = 0.193-1.0). Hypertensive cases with mild regurgitation (N = 22) had significantly enlarged LAV and further reduced LA reservoir function, while the group with moderate regurgitation (N = 20) showed significantly reduced LA pump function, further impaired conduit function, and significantly reduced LV strain. The severe regurgitation (N = 13) group demonstrated significantly more severely impaired LA and LV functions and LAV enlargement. Multivariable linear regression showed that regurgitation degree, GRS, GCS, and GLS were independently correlated with the LA reservoir, conduit, and active strain in hypertensive patients with mitral regurgitation.

Data conclusion: Mitral regurgitation may exacerbate LA and LV impairment in hypertension. Regurgitation degree, LV GRS, GCS, and GLS were independent determinants of the LA strain in hypertensive patients with mitral regurgitation, which demonstrated atrioventricular interaction.

Evidence level: 4.

Technical efficacy: Stage 3.

Keywords: atrioventricular interaction; hypertension; left atrial strain; mitral regurgitation.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Zhou B, Carrillo-Larco RM, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021;398(10304):957-980.
    1. Li XM, Jiang L, Guo YK, et al. The additive effects of type 2 diabetes mellitus on left ventricular deformation and myocardial perfusion in essential hypertension: A 3.0 T cardiac magnetic resonance study. Cardiovasc Diabetol 2020;19(1):161.
    1. Tadic M, Cuspidi C, Celic V, Ivanovic B, Pencic B, Grassi G. The influence of sex on left ventricular strain in hypertensive population. J Hypertens 2019;37(1):50-56.
    1. Yan WF, Gao Y, Zhang Y, et al. Impact of type 2 diabetes mellitus on left ventricular diastolic function in patients with essential hypertension: Evaluation by volume-time curve of cardiac magnetic resonance. Cardiovasc Diabetol 2021;20(1):73.
    1. Hoit BD. Left atrial size and function: Role in prognosis. J Am Coll Cardiol 2014;63(6):493-505.

Publication types

MeSH terms

LinkOut - more resources