¹First Cardiology Clinic, Hippokration Hospital, University of Athens,Athens, Greece

Correspondence: Dr C Tsioufis, First Cardiology Clinic, Hippokration Hospital, University of Athens, 43, Agias Marinas Street, 15127 Melissia, Athens, Greece. E-mail: ktsioufis@hippocratio.gr

Received 10 October 2008; Revised 28 January 2009; Accepted 31 January 2009; Published online 5 March 2009.

Abstract

We investigated whether the type of left ventricular (LV) geometry is associated with left atrial (LA) size as determined either by LA diameter or by volume, indexed for body surface area, in essential hypertensives. A total of 339 consecutive, untreated, hypertensives (aged 51.8 years, 234 males) underwent 24-h ambulatory blood pressure (BP) monitoring and estimation of LA diameter and volume, as well as LV structure and function by echocardiography. LV hypertrophy was present in 130 (38.3%) patients whereas normal geometry (LV-NG), concentric remodeling (LV-CR), concentric hypertrophy (LV-CH) and eccentric hypertrophy (LV-EH) represented 34.5, 27.1, 25.7 and 12.7%, respectively. Patients with either LV-CH or LV-EH had increased LA diameter index compared with those with either LV-NG (by 1.1 mm m^–2, P<0.01 and 1.4 mm m^–2, P=0.003, respectively) or LV-CR (by 1.3 mm m^–2, P=0.003 and 1.6 mm m^–2, P=0.001, respectively). Similarly, patients with either LV-CH or LV-EH had significantly increased LA volume index compared with those with either LV-NG (by 3.2 ml m^–2, P<0.001 and 3.4 ml m^–2, P<0.005, respectively) or LV-CR (by 4.5 and 4.7 ml m^–2, respectively, P<0.001 for both). Multiple linear regression analysis showed that the independent predictors of both LA volume and diameter index were LV mass index, 24-h pulse pressure and E/Em.LA size assessed either by its diameter or by volume is closely related only to LV mass index and not to any specific LV geometric pattern in the early stages of essential hypertension.