Assessment of correlation of mean arterial pressure and left ventricular mass with left atrial volume index in hypertensive patients
DOI:
https://doi.org/10.18203/2349-3933.ijam20251077Keywords:
Hypertension, Mean arterial pressure, Left ventricular mass, Left atrial volume index, Echocardiography, Cardiac remodellingAbstract
Background: Hypertension leads to left ventricular remodeling and left atrial enlargement (LAE), which are critical indicators of hypertensive heart disease. Left atrial volume index (LAVI) is a sensitive marker of LAE and diastolic dysfunction. This study aims to assess the correlation between mean arterial pressure (MAP), left ventricular mass (LVM), and LAVI in hypertensive patients to improve cardiovascular risk stratification.
Methods: This prospective observational study included 50 hypertensive patients admitted to Chettinad Super Speciality Hospital over three months. Using 2D echocardiography, LAVI was measured via the area-length method, while LVM was calculated using the Teichholz cubed formula. Relative wall thickness (RWT) was also determined to characterize left ventricular hypertrophy (LVH). Hemodynamic parameters, including MAP, were recorded. Patients were categorized based on the presence or absence of LVH, and correlations between MAP, LVM, and LAVI were analysed.
Results: Patients aged 60–80 years were predominant (42%), followed by 40–60 years (38%) and 20–40 years (20%). Males constituted 58% of the study group. LVM was higher in the LVH group (0.74) than in non-LVH (0.72). RWT was greater in LVH patients (0.59 versus 0.48), while MAP was lower in LVH patients (101.4 versus 113.5). LAVI was lower in LVH patients (19.4 versus 25.5). A weak positive correlation was found between LAVI and MAP (r=0.3984), indicating that while MAP influences LAVI, other factors may contribute significantly.
Conclusions: Chronically elevated blood pressure leads to structural cardiac remodelling, with LAVI being an early marker of hypertensive heart disease. Monitoring LAVI can aid in risk assessment and treatment planning for hypertensive patients.
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References
Oktay AA, Lavie CJ, Milani RV, Ventura HO, Gilliland YE, Shah S, et al. Current perspectives on left ventricular geometry in systemic hypertension. Prog Cardiovasc Dis 2016; 59:235-46. DOI: https://doi.org/10.1016/j.pcad.2016.09.001
Cuspidi C, Rescaldani M, Sala C. Prevalence of echocardiographic left-atrial enlargement in hypertension: a systematic review of recent clinical studies. Am J Hypertens. 2013;26:456-64. DOI: https://doi.org/10.1093/ajh/hpt001
Milan A, Puglisi E, Magnino C, Naso D, Abram S, Avenatti E, et al. Left atrial enlargement in essential hypertension: role in the assessment of subclinical hypertensive heart disease. Blood Press. 2012;21:88-96. DOI: https://doi.org/10.3109/08037051.2011.617098
Díez J, Frohlich ED. A translational approach to hypertensive heart disease. Hypertension. 2010;55:1-8. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.109.141887
DeMers D, Wachs D. Physiology, mean arterial pressure. StatPearls, Treasure Island (FL): StatPearls Publishing. 2025.
Meaney E, Alva F, Moguel R, Meaney A, Alva J, Webel R. Formula and nomogram for the sphygmomanometric calculation of the mean arterial pressure. Heart. 2000;84:64. DOI: https://doi.org/10.1136/heart.84.1.64
McGhee BH, Bridges EJ. Monitoring arterial blood pressure: what you may not know. Crit Care Nurse. 2002;22:60-4. DOI: https://doi.org/10.4037/ccn2002.22.2.60
Kandil H, Soliman A, Alghamdi NS, Jennings JR, El-Baz A. Using mean arterial pressure in hypertension diagnosis versus using either systolic or diastolic blood pressure measurements. Biomedicines. 2023;11. DOI: https://doi.org/10.3390/biomedicines11030849
Jaafar MS, Hamid O, Khor CS, Yuvaraj RM. Preliminary studies of left ventricular wall thickness and mass of normotensive and hypertensive subjects using m-mode echocardiography. Malays J Med Sci. 2002;9:28-33.
Sihm I, Schroeder AP, Aalkjaer C, Holm M, Mørn B, Mulvany M, et al. The relation between peripheral vascular structure, left ventricular hypertrophy, and ambulatory blood pressure in essential hypertension. Am J Hypertens. 1995;8:987-96. DOI: https://doi.org/10.1016/0895-7061(95)00220-0
Burns J, Sivananthan MU, Ball SG, Mackintosh AF, Mary DASG, Greenwood JP. Relationship between central sympathetic drive and magnetic resonance imaging-determined left ventricular mass in essential hypertension. Circulation. 2007;115:1999-2005. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.668863
Cacciapuoti F, Scognamiglio A, Paoli VD, Romano C, Cacciapuoti F. Left atrial volume index as indicator of left ventricular diastolic dysfunction: Comparation between left atrial volume index and tissue myocardial performance index. J Cardiovasc Ultrasound. 2012;20:25-9. DOI: https://doi.org/10.4250/jcu.2012.20.1.25
Gehlken C, Screever EM, Suthahar N, van der Meer P, Westenbrink BD, Coster JE, et al. Left atrial volume and left ventricular mass indices in heart failure with preserved and reduced ejection fraction. ESC Heart Fail. 2021;8:2458-66. DOI: https://doi.org/10.1002/ehf2.13366
Abdalla M, Booth JN 3rd, Diaz KM, Sims M, Muntner P, Shimbo D. Hypertension and alterations in left ventricular structure and geometry in African Americans: The Jackson Heart Study. J Am Soc Hypertens. 2016;10:550-8. DOI: https://doi.org/10.1016/j.jash.2016.05.010
Guzik BM, McCallum L, Zmudka K, Guzik TJ, Dominiczak AF, Padmanabhan S. Echocardiography predictors of survival in hypertensive patients with left ventricular hypertrophy. Am J Hypertens. 2021;34:636-44. DOI: https://doi.org/10.1093/ajh/hpaa194
Musumeci B, Tini G, Russo D, Sclafani M, Cava F, Tropea A, et al. Left ventricular remodeling in hypertrophic cardiomyopathy: An overview of current knowledge. J Clin Med. 2021;10:1547. DOI: https://doi.org/10.3390/jcm10081547
Ho CY, Day SM, Colan SD, Russell MW, Towbin JA, Sherrid MV, et al. The burden of early phenotypes and the influence of wall thickness in hypertrophic cardiomyopathy mutation carriers: Findings from the HCMNet study. JAMA Cardiol. 2017;2:419-28. DOI: https://doi.org/10.1001/jamacardio.2016.5670
Rojek M, Rajzer M, Wojciechowska W, Gąsowski J, Pizoń T, Czarnecka D. The relation between blood pressure components and left atrial volume in the context of left ventricular mass index. Medicine (Baltimore). 2017;96:e9459. DOI: https://doi.org/10.1097/MD.0000000000009459
Drayer JI, Gardin JM, Brewer DD, Weber MA. Disparate relationships between blood pressure and left ventricular mass in patients with and without left ventricular hypertrophy. Hypertension. 1987;9:II61-4. DOI: https://doi.org/10.1161/01.HYP.9.2_Pt_2.II61
Mittal SR. Mean arterial pressure may affect LV mass even when clinic BP is 120/80 mmHg or less. J Assoc Physicians India. 2013;61:713-5.
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