Department of Cardiology, Nicolas Copernicus Specialist District Hospital in Lodz, Poland.
J Hypertens. 2011 Oct;29(10):1988-93. doi: 10.1097/HJH.0b013e32834a98db.
An enlarged left atrium is associated with increased risk for stroke. However, there are controversies regarding how left atrial size should be measured.
Echocardiography and carotid artery ultrasound were performed in 120 patients with essential hypertension (HT group) and in 64 hypertensive patients admitted with a first-ever ischemic stroke (HT-stroke group). Left atrial size was measured as antero-posterior diameter (LAD) and as left atrial volume (LAV) and indexed to body surface area (LADi/LAVi). All patients were in sinus rhythm and without mitral valve disease.
In the HT-stroke group, LAVi and LADi were significantly larger as compared with the HT group (P ≤ 0.03 for all). In bivariate correlations, larger left atrial size was associated with higher SBPs and DBPs and significant carotid artery stenosis both in HT and HT-stroke groups (all P < 0.05). In multivariate logistic regression analysis, stroke was associated significantly with larger LAVi [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.06-2.65]; left ventricular mass index (OR 1.11, 95% CI 1.03-1.21); significant carotid artery stenosis (OR 1.09, 95% CI 1.03-1.24); and any carotid artery stenosis (OR 1.07, 95% CI 1.03-1.14). Analysis of receiver operating characteristic curves revealed that LAVi was the best left atrial measurement for prediction of stroke (OR 0.77, 95% CI 0.70-0.84).
In hypertensive patients, a first-ever ischemic stroke was associated with larger left atrial size, left ventricular mass index and internal carotid artery stenosis. LAVi was the left atrial measurement most closely associated with ischemic stroke.
左心房增大与中风风险增加相关。然而，关于如何测量左心房大小仍存在争议。
对 120 例原发性高血压患者（HT 组）和 64 例首次发生缺血性中风的高血压患者（HT-中风组）进行超声心动图和颈动脉超声检查。左心房大小采用前后径（LAD）和左心房容积（LAV）测量，并按体表面积指数化（LADi/LAVi）。所有患者均为窦性心律，无二尖瓣疾病。
与 HT 组相比，HT-中风组的 LAVi 和 LADi 明显更大（所有 P 值均≤0.03）。在双变量相关性分析中，左心房增大与 HT 和 HT-中风组的较高 SBP 和 DBP 以及显著颈动脉狭窄均相关（所有 P 值均<0.05）。多元逻辑回归分析显示，中风与较大的 LAVi [比值比（OR）1.73，95%置信区间（CI）1.06-2.65]、左心室质量指数（OR 1.11，95%CI 1.03-1.21）、显著颈动脉狭窄（OR 1.09，95%CI 1.03-1.24）和任何颈动脉狭窄（OR 1.07，95%CI 1.03-1.14）显著相关。接受者操作特征曲线分析显示，LAVi 是预测中风的最佳左心房测量指标（OR 0.77，95%CI 0.70-0.84）。
在高血压患者中，首次发生缺血性中风与左心房增大、左心室质量指数和颈内动脉狭窄有关。LAVi 与缺血性中风的相关性最强。
