Kweki Anthony G, Umuerri Ejiroghene M, Aigbe Fredrick I, Aiwuyo Henry O, Obasohan Austine O
Internal Medicine/Cardiology, Delta State University Teaching Hospital, Oghara, NGA.
Medicine, Delta State University, Abraka, NGA.
Cureus. 2022 Dec 26;14(12):e32954. doi: 10.7759/cureus.32954. eCollection 2022 Dec.
The left atrium contributes significantly to the left ventricular filling as it functions as a reservoir, conduit, and pump. These functions are referred to as the phasic function of the left atrium and they are assessed using left atrial volumes. The left atrial function index on the other hand is a rhythmic independent composite index which is a better marker of left atrial function. The study therefore aimed at comparing left atrial function (using the left atrial function index) among hypertensive heart failure patients, patients with hypertension but not in heart failure, and normotensive patients.
The study was a cross-sectional analytical study that was carried out at Delta State University Teaching Hospital, Nigeria. A total of 80 hypertensive heart failure patients, 80 hypertensive, and 40 normotensive patients who met the inclusion criteria were recruited from the cardiology clinics using the convenience sampling method. The left atrial function index was determined using the volumetric method. Significance was assessed at < 0.05.
The left atrial function index (21.13 ± 8.83 versus 42.28 ± 10.40 versus 50.47 ± 14.37, = 0.001) of the hypertensive heart failure group was significantly lowest when compared with the hypertensive (< 0.001) and normotensive (< 0.001) groups. Although the left atrial function index of the hypertensive group (42.28 ± 10.40) was lower than the normotensive group (50.47 ± 14.37), it was however not found to be significant (= 0.12). Also, the left atrial function index was significantly (= 0.001) worse among the patients with heart failure with reduced ejection fraction (13.5 ± 5.94) compared to heart failure with preserved ejection fraction (40.81 ± 12.12).
Left atrial function index was lowest among hypertensive heart failure patients compared with hypertensive and normotensive cohorts, and it was worse among heart failure with reduced ejection fraction patients. However, there was no significant difference between the left atrial function index of the hypertensive and normotensive groups. As a result, we recommend that the left atrial function index should be incorporated into the routine echocardiographic assessment of patients in our day-to-day clinical practice and large studies should be carried out to determine the cut-off value for the left atrial function.
左心房作为一个储存库、管道和泵，对左心室充盈有重要作用。这些功能被称为左心房的阶段性功能，可通过左心房容积进行评估。另一方面，左心房功能指数是一个与节律无关的综合指数，是左心房功能更好的标志物。因此，本研究旨在比较高血压性心力衰竭患者、高血压但无心力衰竭患者和血压正常患者的左心房功能（使用左心房功能指数）。
本研究为横断面分析研究，在尼日利亚三角州大学教学医院进行。采用便利抽样法，从心脏病诊所招募了80例高血压性心力衰竭患者、80例高血压患者和40例血压正常患者，他们均符合纳入标准。使用容积法测定左心房功能指数。显著性评估采用P<0.05。
与高血压组（P<0.001）和血压正常组（P<0.001）相比，高血压性心力衰竭组的左心房功能指数（21.13±8.83 vs 42.28±10.40 vs 50.47±14.37，P=0.001）显著最低。虽然高血压组的左心房功能指数（42.28±10.40）低于血压正常组（50.47±14.37），但差异无统计学意义（P=0.12）。此外，与射血分数保留的心力衰竭患者（40.81±12.12）相比，射血分数降低的心力衰竭患者（13.5±5.94）的左心房功能指数显著更差（P=0.001）。
与高血压和血压正常队列相比，高血压性心力衰竭患者的左心房功能指数最低，且在射血分数降低的心力衰竭患者中更差。然而，高血压组和血压正常组的左心房功能指数之间无显著差异。因此，我们建议在日常临床实践中，应将左心房功能指数纳入患者的常规超声心动图评估中，并应开展大型研究以确定左心房功能的临界值。
