Cheng, Susan

Gennaro, Juan Pablo Albisu Di

Izzo, Joseph

O&apos

Oparil, Suzanne

Pitt, Bertram

Shah, Amil

Shah, Beejal

Solomon, Scott

Uraizee, Imran

Elsevier - Publisher Connector 

Imaging
E1270
JACC March 27, 2012
Volume 59, Issue 13
EFFECT OF ANTI-HYPERTENSIVE THERAPY ON LEFT ATRIAL FUNCTION IN PATIENTS WITH HYPERTENSIVE 
HEART DISEASE
ACC Moderated Poster Contributions
McCormick Place South, Hall A
Saturday, March 24, 2012, 11:00 a.m.-Noon
Session Title: Imaging: Echo LA
Abstract Category: 22. Imaging: Echo
Presentation Number: 1096-251
Authors: Juan Pablo Albisu Di Gennaro, Susan Cheng, Kaitlyn O’Brien, Beejal Shah, Imran Uraizee, Amil Shah, Joseph Izzo, Suzanne Oparil, Bertram 
Pitt, Scott Solomon, Brigham and Women’s Hospital, Boston, MA, USA
Background:  Prior studies suggest that hypertension is associated with LA dysfunction, even in the presence of normal LA size; whether or not LA 
function can improve with BP lowering therapy is unknown.
Methods:  We studied a subset of 174 patients (55% women) from the Exforge Intensive Control of Hypertension to Evaluate Efficacy in Diastolic 
Dysfunction (EXCEED) trial who underwent 24 weeks of intensive vs standard anti-hypertensive therapy with valsartan + amlodipine (titrated to goal 
SBP <135 vs <140 mmHg) and had baseline and follow-up echocardiography. We used speckle tracking based analyses to examine changes in 
cardiac structure and function; these analyses included measures of LA strain and strain rate during ventricular systole.
Results:  Although most patients (N=144) had normal LA size (<29 mL/m2) at baseline, both LA size and contractile function improved in 
response to anti-hypertensive therapy: LA volume index (LAVI, 25.5±3.5 to 24.2±3.9 ml/m2, P<0.001); LA strain (36.5±8.4 to 38.7±9.2 %, 
P=0.026); and LA strain rate (1.46±0.35 to 1.56±0.37 s-1, P=0.001) (Figure). In multivariable analyses adjusting for clinical and echocardiographic 
covariates, improvement in LA strain was associated with decrease in LAVI (P=0.038) and increase in E’ (P=0.018); improvement in LA strain rate 
was associated with male sex (P=0.005) and decrease in LAVI (P=0.002).
Conclusion:  In patients with hypertensive heart disease, BP lowering can lead to improved LA contractile function as well as decreased LA volume. 


EFFECT OF ANTI-HYPERTENSIVE THERAPY ON LEFT ATRIAL FUNCTION IN PATIENTS WITH HYPERTENSIVE HEART DISEASE 

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EFFECT OF ANTI-HYPERTENSIVE THERAPY ON LEFT ATRIAL FUNCTION IN PATIENTS WITH HYPERTENSIVE HEART DISEASE

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