The effect of urgent blood pressure reduction on left atrial strain in patients with hypertensive attack Blood pressure lowering affects LA strain

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dc.authoridGüvenç, Tolga Sinan/0000-0002-6738-266X
dc.authoridsert, sena/0000-0002-3735-1053
dc.authoridDINC ASARCIKLI, LALE/0000-0002-7828-9487
dc.authorwosidGüvenç, Tolga Sinan/AAK-6020-2020
dc.contributor.authorAsarcikli, Lale Dinc
dc.contributor.authorCan, Fatma
dc.contributor.authorGuvenc, Tolga Sinan
dc.contributor.authorSert, Sena
dc.contributor.authorOsken, Altug
dc.contributor.authorDayi, Sennur Unal
dc.date.accessioned2024-05-19T14:39:30Z
dc.date.available2024-05-19T14:39:30Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
dc.description.abstractBackground: Left atrial (LA) strain is a robust measure of LA function and is a useful parameter to assess left ventricular filling pressure. While initially considered as a load-independent parameter of LA function, later studies have found that acute changes in LA preload may affect LA reservoir and contractile strains. Acute alterations in blood pressure (BP) induces a change in left ventricular (LV) filling pressure without imposing a volume load, thus providing an opportunity to assess the effects of the change in LA afterload on LA mechanics. This study aims to understand the effect of acute BP changes on LA strain. Methods: A total of 40 patients admitted to the emergency department with hypertensive urgency were included. All patients underwent a comprehensive echocardiographic examination including measurement of LA reservoir, conduit and contractile strains. A repeat set of measurements were obtained after BP lowering. Results: Average drop in mean BP following intervention was 18.1 +/- 5.4%. LV end-systolic and end-diastolic volumes, as well as maximum and minimum LA volumes were decreased significantly after BP reduction. The absolute increases in reservoir and contractile strains were 2.3 +/- 4.7% (7.9% +/- 13.8% relative to baseline) and 2.5 +/- 3.3% (13.5 +/- 19.0% relative to baseline), respectively, with both changes being statistically significant (p = 0.003 for reservoir and p < 0.001 for contractile strains). There were no significant changes in conduit strain after BP intervention (p = 0.79). The change in both LA reservoir and contractile strains were more evident in those with a previous diagnosis of hypertension and those with a smaller degree of change in mean BP after intervention. Conclusion: In patients with an acute hypertension, lowering BP leads to an acute improvement in LA reservoir and contractile strains. Thus, acute changes in systemic BP should be considered when LA mechanics are evaluated.en_US
dc.identifier.doi10.1007/s10554-023-02828-8
dc.identifier.endpage1230en_US
dc.identifier.issn1569-5794
dc.identifier.issn1875-8312
dc.identifier.issue7en_US
dc.identifier.pmid37093309en_US
dc.identifier.scopus2-s2.0-85153374868en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage1221en_US
dc.identifier.urihttps://doi.org10.1007/s10554-023-02828-8
dc.identifier.urihttps://hdl.handle.net/20.500.12713/4792
dc.identifier.volume39en_US
dc.identifier.wosWOS:000974968100001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofInternational Journal of Cardiovascular Imagingen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240519_kaen_US
dc.subjectBlood Pressureen_US
dc.subjectLeft Atrial Strainen_US
dc.subjectSpeckle Tracking Echocardiographyen_US
dc.subjectHypertensionen_US
dc.subjectLeft Ventricular Filling Pressureen_US
dc.titleThe effect of urgent blood pressure reduction on left atrial strain in patients with hypertensive attack Blood pressure lowering affects LA strainen_US
dc.typeArticleen_US

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