Left atrial remodeling and dysfunction in primary aldosteronism
F Yan, L cheng, Y Wang, L W BaoAbstract
Background
As primary aldosteronism (PA) is associated with an increased risk of cardiovascular events, including atrial fibrillation and heart failure, this study utilized three-dimensional echocardiography to investigate left atrial (LA) remodeling and dysfunction, aiming for early identification of cardiac dysfunction.
Methods
In this cross-sectional study, 61 participants were enrolled, including 24 PA (63.00±11.88y, 54.2% male), 13 essential hypertension (EH) (68.38±8.78y, 69.2% male) and 24 healthy volunteers (62.83±7.64y, 66.6% male). Two/three-dimensional echocardiography and strain imaging were used to acquire parameters of LA structure, function, and strain, as well as left ventricular (LV) structure and function in enrolled individuals. One-way ANOVA and non-parametric tests were used to analyze inter-group differences using Stata 15.0.
Results
Significantly increased LA Vmin, LA Vmax, LA VpreA, and LA VImax (25.80±6.06 vs 17.54±6.30ml, 50.47±9.16 vs39.25±12.06ml, 40.40±8.84 vs 29.79±9.39ml, 32.73±16.31 vs 22.46±6.70ml/m2, all p < 0.05) and reduced LAEF, LASr_c, and LASct_c (48.93±7.97 vs 55.67±7.73%, 26.93±8.25 vs 34.75±9.74%, -17.80±5.95 vs -22.75±7.55%, all p < 0.05) were observed in PA group compared with healthy volunteers. Meanwhile, significantly lower LAEF and LASr_c (48.93±7.97 vs 55.15±4.93%, 26.93±8.25 vs 33.46±6.57%, both p < 0.05) were observed in PA group compared to the HTN group. Additionally, LV strain parameters were significantly lower in PA compared with the HTN group (-18.37±2.26 vs -20.54±3.25%, p < 0.05).
Conclusions
PA is associated with increased LA volume index and decreased LA reservoir and pump function. LA dysfunction may be the key pathophysiological change leading to atrial fibrillation and heart failure in PA.LA straining imaging