Enhanced Left Atrial Reservoir, Increased Conduit, and Weakened Booster Pump Function in Hypertensive Patients with Paroxysmal Atrial Fibrillation

Abstract

The aim of this study was to evaluate whether paroxysmal atrial fibrillation (PAF) has an impact on left atrial (LA) function in hypertensive patients and, if so, to select clinical factors influencing this relationship. Sixty-four essential hypertensive patients with PAF (group EHf) and fifty-five patients without PAF (group EH) were enrolled. Using acoustic quantification, the maximal and minimum LA volume (LAVmax, LAVmin), the LA volume at the end of rapid emptying (EREV), and the LA volume at the onset of atrial emptying (OAEV) were measured. The LA total emptying volume (TE; TE=LAVmax-LAVmin), LA rapid emptying volume (RE; RE=LAVmax-EREV), and left atrial ejection fraction (LAEF)=(OAEV-LAVmin)/OAEVx100% were calculated. LAVmax, LAVmax indexed to body surface area (LAVmaxI), TE and RE were significantly increased in group EHf. LAEF was clearly lower in group EHf than in group EH. The linear regression analysis showed that the frequency and total number of PAF episodes were the factors with the greatest influence on LAVmaxI (r=0.787, p<0.05). TE and frequency of PAF episodes were the most influential factors on RE (r=0.902, p<0.01). These results suggest that the occurrence of PAF in hypertensive patients is associated with enhanced LA reservoir and conduit function and worse booster pump function. The enhancement of LA reservoir function may be related to the frequency and total number of PAF episodes, and the increased LA conduit function may be related to the LA total emptying volume and frequency of PAF episodes.