Impact of blood pressure control on left atrial diastolic function as determined by 2D speckle tracking echocardiography

Abstract Aim and Objectives: The study's objective is to investigate, in recently diagnosed individuals with systemic hypertension, the impact of appropriate blood pressure control on left atrial functions as assessed by 2D speckle echocardiography and electrocardiogram. Patients and Methods: Fifty patients with newly diagnosed systemic arterial hypertension who presented to Ain Shams University Hospitals were included in the study. The patients' demographic information, risk factors, general and local examinations, 12-lead ECGs, 2D speckle tracking echocardiograms, and laboratory measurements were evaluated. Following six months of appropriate blood pressure (BP) control in accordance with JNC 10, the patients were followed up. Results PALS (peak atrial longitudinal strain) increased in the current study, with a mean change of 35.04 ± 4.33 to 38.92 ± 5.52 and a P-value < 0. 001. The mean of PACS (peak atrial contraction strain) increased from 17.38 ± 4.67 to 20.46 ± 4.39, with a P-value of less than 0.001. The mitral peak early (E) and the septal mitral annular velocities (e`) and their average E/e' showed decrease with change of the mean from 8.8 ± 0.93 to 7.8 ± 1.16, with a P-value of less than 0.001. The mean of the left atrial stiffness index (LASI) decreased from 0.24 ± 0.04 to 0.2 ± 0.03, with a P-value less than 0.001. The ECG follow-up showed no discernible change in the P wave's duration or amplitude with P values of 0.135 and 0.785 respectively. Conclusion The results of this study showed that patients with hypertension may benefit from using speckle tracking imaging to identify mild impairment of left atrial (LA) function. PALS, PACS, E/e', and LASI improve in hypertensive patients when blood pressure is well controlled. Further research is warranted to better understand the significance of LA function using speckle tracking echocardiography (STE) in the prediction of atrial fibrillation and the risk of heart failure with preserved ejection fraction. This study highlights how important it is to measure LA function in hypertensive patients.