M. Bilge et al., Effect of blood pressure reduction on abnormal left atrial appendage function in untreated systemic hypertensive patients with sinus rhythm, ANGIOLOGY, 52(9), 2001, pp. 621-626
To investigate whether reduction in blood pressure has a beneficial effect
on left atrial appendage (LAA) function, the authors evaluated 24 untreated
systemic hypertensive patients with normal left ventricular systolic funct
ion in sinus rhythm at baseline and at 3 months after initiation of anti hy
pertensive therapy. They performed transthoracic and transesophageal echoca
rdiographic examinations in hypertensive patients before and after treatmen
t of hypertension. Three of the 24 patients had blood pressure that failed
to respond to the regimen of antihypertensive therapy and were removed from
the analysis. Of the remaining 21 patients, mean systolic and diastolic bl
ood pressures at baseline were 170 +/- 18 and 104 +/-6 mm Hg, respectively,
and fell significantly at 3 months to 141 +/- 10 and 90 +/-5 mm Hg, respec
tively, (p <0.001) after initiation of antihypertensive therapy. There was
no significant change in heart rate with treatment (baseline 81 +/-8 and at
3 months 84 +/-9 beats/min). There was no significant change in left ventr
icular end-diastolic diameter, left ventricular ejection fraction, left ven
tricular wall thickness, or left atrial diameter from baseline (49 +/-4 mm,
58 +/-5%, 12 +/-1 mm, and 41 +/-4 mm, respectively) at 3 months (48 +/-5 m
m, 59 +/-4%,12 +/-1 mm, and 40 +/-3 mm). The treatment caused a significant
reduction in maximal LAA areas (6.3 +/- 13 cm(2) at baseline, 4.6 +/-0.7 c
m(2) at 3 months, p <0.001), with a concomitant increase in LAA emptying ve
locity (44 +/-7 cm/sec at baseline, 60 +/-9 cm/sec at 3 months, p <0.001).
In conclusion, these findings suggest that reduction in blood pressure with
antihypertensive therapy could improve LAA function in hypertensive patien
ts with normal left ventricular systolic function in sinus rhythm.