Association of left atrial enlargement with ventricular remodeling in hypertensive Chinese elderly

Peng, Jing; Laukkanen, Jari A.; Zhao, Qianping; Wang, Liping; Zhang, Xu; Li, Gang

doi:10.1111/echo.13484

Cited by 6 publications

(7 citation statements)

References 28 publications

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“…According to American Society of Echocardiography leading-edge method, transthoracic color doppler echocardiographic studies were performed and read by experienced cardiologists in a single core laboratory in our hospital, with a Vivid echocardiographic system (General Electric Co., Fairfield, CT, USA), which was equipped with a 3.5-MHz sector scan transducer 20 . Two-dimensional guided M-mode measurement of right ventricular (RV) diameter, interventricular septal thickness, left ventricular (LV) posterior wall thickness and end-diastolic inner diameter were examined at end-diastole from the parasternal long-axis view; Right atrial (RA), left atrial (LA) and LV end-systolic inner diameter were measured at end-systole from the parasternal long-axis view; The methods for the calculation of LV mass index and ejection fraction were the same as described previously 16 , 17 , 20 .…”

Section: Methodsmentioning

confidence: 99%

Low body mass is associated with reduced left ventricular mass in Chinese elderly with severe COPD

Zhang

Laukkanen

et al. 2021

Sci Rep

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There is limited information on the association of body mass index (BMI) with left ventricular (LV) remodeling corresponding to severity of reduced lung function in patients with chronic obstructive pulmonary disease (COPD). Therefore, we investigated whether BMI is associated with cardiac atrial and ventricular dimensions according to severity of lung functional impairment in Chinese COPD elderly. A total of 563 hospitalized COPD patients with lung function impairment and 184 patients with non-COPD (aged 65–92 years) were collected retrospectively in a cross-sectional study in a university affiliated tertiary hospital in China. BMI and cardiac echocardiographic parameters were compared according to severity of lung functional impairment in COPD patients. BMI was 22.9 ± 3.9 kg/m2 in COPD patients, 24.0 ± 4.1 kg/m2 in non-COPD patients respectively. Reduced BMI, LV mass index, LV wall thickness and left atrial diameter, and dilated right ventricle (RV) existed in COPD patients with severe lung dysfunction as compared the COPD patients with mild to moderate lung functional reduction and non-COPD patients (P < 0.05), while there were no differences in BMI and echocardiographic parameters between the COPD patients with mild to moderate lung functional decline and non-COPD patients (P > 0.05). Logistic regression analysis showed that low BMI (BMI < 18.5 kg/m2) was correlated with reduced LV mass and wall thickness, dilated RV and reduced lung function in the COPD patients with severe lung dysfunction. In conclusion, this study demonstrates that lower BMI is associated not only with dilated RV and impaired pulmonary function, but also it is related to reduced LV mass in Asian COPD elderly with severe lung dysfunction.

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Section: Methodsmentioning

confidence: 99%

Low body mass is associated with reduced left ventricular mass in Chinese elderly with severe COPD

Zhang

Laukkanen

et al. 2021

Sci Rep

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“…Among them, 98 subjects were firstly diagnosed with primary hypertension; 103 subjects were treated only with lifestyle modification. Hypertension criteria included an average untreated casual systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg at clinical visits 7,8 . Type 2 diabetes mellitus (DM) was defined by fasting plasma glucose (FPG) ≥ 7 mmol/L or 2 hours postprandial plasma glucose (PPG) ≥ 11.1 mmol/L in oral glucose tolerance test; Moreover, plasma insulin concentration is normal or increased in the subjects 9 .…”

Section: Methodsmentioning

confidence: 99%

“…Two-dimensional–guided M-mode measurement of right ventricular diameter (RVD), aortic diameter (AOD), interventricular septal thickness (IVST), left ventricular (LV) posterior wall thickness (LVPWT) and end-diastolic diameter (LVEDD) were examined at end-diastole from the parasternal long-axis view; Left atrial diameter (LAD) and LV end-systolic diameter (LVESD) were measured at end-systole from the parasternal long-axis view; LV mass (LVM) g = (0.80 · 1.04 · ((LVEDD mm + IVST mm + LVPWT mm) 3 - (LVEDD mm) 3 ) + 0.6) · 0.001; LVMI g/m 2.7 = LVM g/(height m) 2.7 ; LV peak early (E) and late (A) filling velocities were measured. E/A reversal prevalence, LV ejection fraction (LVEF) and fractional shortening (LVFS) were examined 8,12,13 .…”

Section: Methodsmentioning

confidence: 99%

Overweight and obesity are associated with cardiac adverse structure remodeling in Chinese elderly with hypertension

Liu

Laukkanen

et al. 2019

Sci Rep

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There is limited information on the association of overweight and obesity with cardiac remodeling in elderly population. Therefore, we investigated whether overweight and obesity are associated with cardiac geometric structures and function in Chinese elderly. A total of 1183 hospitalized patients (aged 65–99 years) with primary hypertension were collected retrospectively in a cross-sectional study, and divided into underweight, normal weight, overweight and obesity patient groups according to their body mass index (BMI). Cardiac echocardiographic parameters were compared between the groups. BMI was 17.2 ± 1.2, 21.4 ± 1.2, 25.1 ± 1.2, 30.2 ± 2.6 kg/m2 in underweight, normal weight, overweight and obesity groups respectively. Aortic and left atrial diameter, interventricular septal and left ventricular (LV) posterior wall thickness, LV end-diastolic and end-systolic diameter, and indexed LV mass, and prevalence of E/A reversal were higher, while LV ejection fraction and fractional shortening were lower in elderly with overweight or obesity, as compared with whose with underweight or normal weight separately (All P < 0.05). However, multivariable regression analysis showed that overweight and obesity are independently related to increased LV wall thickness, end-diastolic diameter and mass (All P < 0.05). In conclusions, this study demonstrates that overweight and obesity are associated with increased LV wall thickness, end-diastolic diameter and mass in Asian elderly.

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“…The risk factors for LACI are advanced age, chronic hypertension, smoking and diabetes mellitus [ 4 ]. Among these known risk factors, hypertension, the leading cause of LACI, affects 50% of Chinese adults aged 35-75 years [ 5 ]. Hypertension was the main cerebrovascular risk factor only for lacunar infarct and atherothrombotic infarction, that is, ischemic stroke associated with small- and large-artery disease [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…From 1991 to 2011, approximately one-fifth of Chinese adults were hypertensive, but only 17.5% of hypertension was controlled. Peng J et al studied 480 elderly hypertensive Chinese patients and found that left atrial enlargement is independently associated with a longer duration of hypertension in elderly hypertensive patients with preserved LVEF [ 5 ]. Since there is a positive association between left atrial enlargement and hypertension and hypertension is an important pathogenesis of LACI, we hypothesize that LACI is associated with left atrial size in hypertensive patients.…”

Section: Introductionmentioning

confidence: 99%

Relation between left atrial structure and lacunar infarction in patients with hypertension

Sun

Xie

Zhang

et al. 2020

Aging

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A lacunar infarction (LACI) can cause damage to the surrounding brain tissue and place an individual at greater risk for future major stroke. LACI is associated with hypertension and hypertension is associated with left atrial enlargement. It is important to identify a high-risk patient who is more vulnerable to suffering a LACI in hypertensive group. So, we studied whether left atrium size is an independent risk predictor for LACI in hypertensive patients. We performed cross-sectional analysis of 365 patients with hypertension at Shanghai Ninth People’s Hospital from January 2016 to January 2017. The results showed that left atrial diameter(LAD), left atrial volume (LAV) and the ratio of left atrial diameter to left ventricular diameter (LAD/LVD) were significantly associated with LACI in hypertensive patients. Based on the ROC curve analysis, the area under the ROC curve (AUC) of LAV used to predict LACI was 0.737 (95% CI: 0.686 – 0.788), and the AUC of LAD/LVD was 0.784 (95% CI: 0.737 – 0.830). The optimal cut-off value for LAV was 30.14, and the sensitivity and specificity were 72% and 63%, respectively. The optimal cut-off value for LAD/LVD was 0.757, and the sensitivity and specificity were 77% and 70%, respectively. LAV or LAD/LVD played an important role in LACI with hypertension and could be an independent risk factor in hypertensive patients.

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Association of left atrial enlargement with ventricular remodeling in hypertensive Chinese elderly

Abstract: Left atrial enlargement is independently associated with a longer duration of hypertension and RV dilative remodeling in hypertensive elderly with preserved LVEF. LA enlargement is an early sign of RV eccentric remodeling in hypertensive elderly.

Cited by 6 publications

References 28 publications

Low body mass is associated with reduced left ventricular mass in Chinese elderly with severe COPD

Low body mass is associated with reduced left ventricular mass in Chinese elderly with severe COPD

Overweight and obesity are associated with cardiac adverse structure remodeling in Chinese elderly with hypertension

Relation between left atrial structure and lacunar infarction in patients with hypertension

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