Relation of left atrial ejection force to left ventricular function in arterial hypertension

The left atrial ejection force (LAEF), defined as that force exerted by the left atrium (LA) to accelerate the blood into the left ventricle during at rial systole, is well accepted for the evaluation of LA systolyc function. The aim of this study is to determine whether LAEF is a precursor of the im pairement of LV systolic function in patients with arterial hypertension (H TN). For that purpose we studied LAEF in 36 patients with HTN (av. age 58 /- 8 years) with LV hypertrophy (Lvmi>134 g/m(2) for men and >110 g/m(2) fo r women). LV systolic function estimated by the fractional shortening (FSh) was 35 +/- 4% (28 to 44); 32 normal subjets (NS) were also analyzed, All s ubjetcts were submitted to echo and doppler examinations, Methods: LAEF was obtained by the formula : 1/3 x MVA x (A-vel)(2), where M VA is mitral valve area measured by 2D echo while A-vel. is the late diasto lic (atrial) mitral velocity. Results: 1, LAEF increased significantly with age in NS (r=0.78) p<0.05). A ge corrected LEAF was calculated as % LEAF=(actual LAEF/normal LAEF x 100, 2. Compared to NS, % LAEF was lower in HTN (78 +/- 25 %). 3. There was a si gnificant inverse correlation between LAEF and LV wall thickness (r=-0.46) (p<0.05). 4. % LAEF was 66 +/- 31 % in patients with FSh <33 % and 79 +/- 2 5 % in those with FSh >33 % (p<0.05). 5. In HTN with the duration >15 years , % LAEF was lower than in patients with <15 years (62 +/- 25 vs 76 +/- 24) (p<0.05). Conclusions: 1. LAEF is decreased in more advance stages of HTN. 2. This im pairment is related to LV hypertrophy and to the duration of the disease. 3 . LAEF is a sensitive precursor for LV systolic deterioration in patients w hith hypertension.