Left Atrial Enlargement by Echocardiography: An Early Sign of Hypertensive Heart Disease

Abstract

Left atrial abnormality on the electrocardiogram (ECG) has been considered an early sign of hypertensive heart disease. In order to determine if echocardiographic left atrial enlargement is an early sign of hypertensive heart disease, we evaluated 12 normal and 20 hypertensive patients for echocardiographic left atrial enlargement. All patients had sinus rhythm, normal left ventricular volumes and function, no valvular disease, and no echocardiographic or ECG left ventricular hypertrophy. No patient met ECG criteria for left atrial abnormality. The mean left atrial dimension was 3.25± 0.2 cm in normal individuals versus 4.12± 0.2 cm in the hypertensive patients (p<0.02). The let article index was also higher in the hypertensive group, 2.13± 0.38 versus 1.81± 0.12cm/m2 (p<0.04). Left atrial to aortic root dimension ratio was significantly higher in the hypertensive group, 1.39± 0.3 versus 1.16± 0.10 (p<0.02). We conclude that echocardiographic left atrial enlargement may be an early sign of hypertensive heart disease in patients with no other apparent cause of left atrial enlargement.