Left atrial dilatation: A target organ damage in young to middle-age hypertensive patients. The Campania Salute Network
Left atrial (LA) volume is a predictor of outcome in hypertension. It is unclear whether or not this effect depends on coexisting target organ damage (TOD). To investigate whether LA volume predicts outcome independently of TOD [left ventricular (LV) hypertrophy (LVH) and/or carotid plaque] in a reg...
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| Veröffentlicht in: | International journal of cardiology 2018-08, Vol.265, p.229-233 |
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| container_title | International journal of cardiology |
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| creator | Mancusi, Costantino Canciello, Grazia Izzo, Raffaele Damiano, Silvia Grimaldi, Maria Gabriella de Luca, Nicola de Simone, Giovanni Trimarco, Bruno Losi, Maria-Angela |
| description | Left atrial (LA) volume is a predictor of outcome in hypertension. It is unclear whether or not this effect depends on coexisting target organ damage (TOD).
To investigate whether LA volume predicts outcome independently of TOD [left ventricular (LV) hypertrophy (LVH) and/or carotid plaque] in a registry of hypertensive treated patients.
From the Campania Salute Network registry, we selected 5844 young adult hypertensive patients |
| doi_str_mv | 10.1016/j.ijcard.2018.03.120 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2023405332</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167527317375149</els_id><sourcerecordid>2023405332</sourcerecordid><originalsourceid>FETCH-LOGICAL-c362t-26010ceaef92fcfa05f77e831632fb34f46e707c5c8fa11cc24d9125e5ee37913</originalsourceid><addsrcrecordid>eNp9kE1v1DAQhi0EokvhH1TIRy4J_kjihEOlagW00goOtGdrao-33iZxsJ2u9t83qy09chpp9LzvaB5CLjgrOePN113pdwaiLQXjbclkyQV7Q1a8VVXBVV29JasFU0UtlDwjH1LaMcaqrmvfkzPRNaIVql2R_QZdppCjh55a30OG7MP4jV7RDHGLmYa4hZFaGGCL1I_0EOZxS3Ogg7e2x-K4fjhMGDOOyT8hnZYGHHMq6e0D0jUME4we6B_o54z0F-Z9iI8fyTsHfcJPL_Oc3P34fru-Lja_f96srzaFkY3IhWgYZwYBXSecccBqpxS2kjdSuHtZuapBxZSpTeuAc2NEZTsuaqwRpeq4PCdfTr1TDH9nTFkPPhnsexgxzEkLJmTFainFglYn1MSQUkSnp-gHiAfNmT4q1zt9Uq6PyjWTelG-xD6_XJjvB7SvoX-OF-DyBODy55PHqJNZBBm0PqLJ2gb__wvPebaVDw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2023405332</pqid></control><display><type>article</type><title>Left atrial dilatation: A target organ damage in young to middle-age hypertensive patients. The Campania Salute Network</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Mancusi, Costantino ; Canciello, Grazia ; Izzo, Raffaele ; Damiano, Silvia ; Grimaldi, Maria Gabriella ; de Luca, Nicola ; de Simone, Giovanni ; Trimarco, Bruno ; Losi, Maria-Angela</creator><creatorcontrib>Mancusi, Costantino ; Canciello, Grazia ; Izzo, Raffaele ; Damiano, Silvia ; Grimaldi, Maria Gabriella ; de Luca, Nicola ; de Simone, Giovanni ; Trimarco, Bruno ; Losi, Maria-Angela</creatorcontrib><description>Left atrial (LA) volume is a predictor of outcome in hypertension. It is unclear whether or not this effect depends on coexisting target organ damage (TOD).
To investigate whether LA volume predicts outcome independently of TOD [left ventricular (LV) hypertrophy (LVH) and/or carotid plaque] in a registry of hypertensive treated patients.
From the Campania Salute Network registry, we selected 5844 young adult hypertensive patients <65 years old (mean age 50 ± 9 years, 41% women, 8% diabetic) without prevalent CV or valvular heart disease more than mild, with normal LV ejection fraction, stage III or less CKD and available follow-up. LA volume was estimated from LA diameter applying a validated nonlinear equation, and indexed to body height in meters to the second power (eLAVI). Composite fatal and non-fatal stroke, myocardial infarction, sudden cardiac death, heart failure, TIA, myocardial revascularization, de novo angina, carotid stenting or atrial fibrillation (AF) were adjudicated as incident CV events.
565 (10%) patients exhibited dilated initial eLAVI. During a median follow-up of 49 months, 233 patients developed CV events. Multivariable Cox regression analysis, demonstrated that dilated eLAVI increased risk of incident composite CV events (HR 1.90, 95%CI 1.26–2.88, p = 0.002), independently of significant effect of older age, male sex, presence LVH and carotid plaque.
Conclusions
In middle aged, treated hypertensive patients, dilated eLAVI is associated with adverse CV risk profile and is a predictor of CV events independently of other markers of TOD. LA dilatation should be considered as a TOD.
•LA dilatation is a strong predictor of worse outcome in young to middle age patients with hypertension even when AF development is excluded as end point.•In the setting of young to middle age patients with well controlled BP during follow-up, LA dilatation is the only CV ultrasound parameter capable to predict worse prognosis.•Consistent with previous studies, presence of dilated eLAVI was associated with a worse clinical CV risk profile, in particular higher prevalence of associated CV target organ damage.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2018.03.120</identifier><identifier>PMID: 29628278</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Age Factors ; Atrial Function, Left - physiology ; Carotid plaque ; CV outcome ; Diastolic function ; Female ; Follow-Up Studies ; Heart Atria - diagnostic imaging ; Heart Atria - physiopathology ; Humans ; Hypertension - diagnostic imaging ; Hypertension - epidemiology ; Hypertension - physiopathology ; Intima media thickness ; Male ; Middle Aged ; Organ Size ; Registries ; Ventricular hypertrophy</subject><ispartof>International journal of cardiology, 2018-08, Vol.265, p.229-233</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-26010ceaef92fcfa05f77e831632fb34f46e707c5c8fa11cc24d9125e5ee37913</citedby><cites>FETCH-LOGICAL-c362t-26010ceaef92fcfa05f77e831632fb34f46e707c5c8fa11cc24d9125e5ee37913</cites><orcidid>0000-0002-0308-2836 ; 0000-0001-8567-9881 ; 0000-0002-0701-6449 ; 0000-0001-6690-1408</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0167527317375149$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29628278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mancusi, Costantino</creatorcontrib><creatorcontrib>Canciello, Grazia</creatorcontrib><creatorcontrib>Izzo, Raffaele</creatorcontrib><creatorcontrib>Damiano, Silvia</creatorcontrib><creatorcontrib>Grimaldi, Maria Gabriella</creatorcontrib><creatorcontrib>de Luca, Nicola</creatorcontrib><creatorcontrib>de Simone, Giovanni</creatorcontrib><creatorcontrib>Trimarco, Bruno</creatorcontrib><creatorcontrib>Losi, Maria-Angela</creatorcontrib><title>Left atrial dilatation: A target organ damage in young to middle-age hypertensive patients. The Campania Salute Network</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Left atrial (LA) volume is a predictor of outcome in hypertension. It is unclear whether or not this effect depends on coexisting target organ damage (TOD).
To investigate whether LA volume predicts outcome independently of TOD [left ventricular (LV) hypertrophy (LVH) and/or carotid plaque] in a registry of hypertensive treated patients.
From the Campania Salute Network registry, we selected 5844 young adult hypertensive patients <65 years old (mean age 50 ± 9 years, 41% women, 8% diabetic) without prevalent CV or valvular heart disease more than mild, with normal LV ejection fraction, stage III or less CKD and available follow-up. LA volume was estimated from LA diameter applying a validated nonlinear equation, and indexed to body height in meters to the second power (eLAVI). Composite fatal and non-fatal stroke, myocardial infarction, sudden cardiac death, heart failure, TIA, myocardial revascularization, de novo angina, carotid stenting or atrial fibrillation (AF) were adjudicated as incident CV events.
565 (10%) patients exhibited dilated initial eLAVI. During a median follow-up of 49 months, 233 patients developed CV events. Multivariable Cox regression analysis, demonstrated that dilated eLAVI increased risk of incident composite CV events (HR 1.90, 95%CI 1.26–2.88, p = 0.002), independently of significant effect of older age, male sex, presence LVH and carotid plaque.
Conclusions
In middle aged, treated hypertensive patients, dilated eLAVI is associated with adverse CV risk profile and is a predictor of CV events independently of other markers of TOD. LA dilatation should be considered as a TOD.
•LA dilatation is a strong predictor of worse outcome in young to middle age patients with hypertension even when AF development is excluded as end point.•In the setting of young to middle age patients with well controlled BP during follow-up, LA dilatation is the only CV ultrasound parameter capable to predict worse prognosis.•Consistent with previous studies, presence of dilated eLAVI was associated with a worse clinical CV risk profile, in particular higher prevalence of associated CV target organ damage.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Atrial Function, Left - physiology</subject><subject>Carotid plaque</subject><subject>CV outcome</subject><subject>Diastolic function</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - physiopathology</subject><subject>Humans</subject><subject>Hypertension - diagnostic imaging</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Intima media thickness</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Size</subject><subject>Registries</subject><subject>Ventricular hypertrophy</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EokvhH1TIRy4J_kjihEOlagW00goOtGdrao-33iZxsJ2u9t83qy09chpp9LzvaB5CLjgrOePN113pdwaiLQXjbclkyQV7Q1a8VVXBVV29JasFU0UtlDwjH1LaMcaqrmvfkzPRNaIVql2R_QZdppCjh55a30OG7MP4jV7RDHGLmYa4hZFaGGCL1I_0EOZxS3Ogg7e2x-K4fjhMGDOOyT8hnZYGHHMq6e0D0jUME4we6B_o54z0F-Z9iI8fyTsHfcJPL_Oc3P34fru-Lja_f96srzaFkY3IhWgYZwYBXSecccBqpxS2kjdSuHtZuapBxZSpTeuAc2NEZTsuaqwRpeq4PCdfTr1TDH9nTFkPPhnsexgxzEkLJmTFainFglYn1MSQUkSnp-gHiAfNmT4q1zt9Uq6PyjWTelG-xD6_XJjvB7SvoX-OF-DyBODy55PHqJNZBBm0PqLJ2gb__wvPebaVDw</recordid><startdate>20180815</startdate><enddate>20180815</enddate><creator>Mancusi, Costantino</creator><creator>Canciello, Grazia</creator><creator>Izzo, Raffaele</creator><creator>Damiano, Silvia</creator><creator>Grimaldi, Maria Gabriella</creator><creator>de Luca, Nicola</creator><creator>de Simone, Giovanni</creator><creator>Trimarco, Bruno</creator><creator>Losi, Maria-Angela</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0308-2836</orcidid><orcidid>https://orcid.org/0000-0001-8567-9881</orcidid><orcidid>https://orcid.org/0000-0002-0701-6449</orcidid><orcidid>https://orcid.org/0000-0001-6690-1408</orcidid></search><sort><creationdate>20180815</creationdate><title>Left atrial dilatation: A target organ damage in young to middle-age hypertensive patients. The Campania Salute Network</title><author>Mancusi, Costantino ; Canciello, Grazia ; Izzo, Raffaele ; Damiano, Silvia ; Grimaldi, Maria Gabriella ; de Luca, Nicola ; de Simone, Giovanni ; Trimarco, Bruno ; Losi, Maria-Angela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-26010ceaef92fcfa05f77e831632fb34f46e707c5c8fa11cc24d9125e5ee37913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Atrial Function, Left - physiology</topic><topic>Carotid plaque</topic><topic>CV outcome</topic><topic>Diastolic function</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - physiopathology</topic><topic>Humans</topic><topic>Hypertension - diagnostic imaging</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Intima media thickness</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Size</topic><topic>Registries</topic><topic>Ventricular hypertrophy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mancusi, Costantino</creatorcontrib><creatorcontrib>Canciello, Grazia</creatorcontrib><creatorcontrib>Izzo, Raffaele</creatorcontrib><creatorcontrib>Damiano, Silvia</creatorcontrib><creatorcontrib>Grimaldi, Maria Gabriella</creatorcontrib><creatorcontrib>de Luca, Nicola</creatorcontrib><creatorcontrib>de Simone, Giovanni</creatorcontrib><creatorcontrib>Trimarco, Bruno</creatorcontrib><creatorcontrib>Losi, Maria-Angela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mancusi, Costantino</au><au>Canciello, Grazia</au><au>Izzo, Raffaele</au><au>Damiano, Silvia</au><au>Grimaldi, Maria Gabriella</au><au>de Luca, Nicola</au><au>de Simone, Giovanni</au><au>Trimarco, Bruno</au><au>Losi, Maria-Angela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left atrial dilatation: A target organ damage in young to middle-age hypertensive patients. The Campania Salute Network</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2018-08-15</date><risdate>2018</risdate><volume>265</volume><spage>229</spage><epage>233</epage><pages>229-233</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>Left atrial (LA) volume is a predictor of outcome in hypertension. It is unclear whether or not this effect depends on coexisting target organ damage (TOD).
To investigate whether LA volume predicts outcome independently of TOD [left ventricular (LV) hypertrophy (LVH) and/or carotid plaque] in a registry of hypertensive treated patients.
From the Campania Salute Network registry, we selected 5844 young adult hypertensive patients <65 years old (mean age 50 ± 9 years, 41% women, 8% diabetic) without prevalent CV or valvular heart disease more than mild, with normal LV ejection fraction, stage III or less CKD and available follow-up. LA volume was estimated from LA diameter applying a validated nonlinear equation, and indexed to body height in meters to the second power (eLAVI). Composite fatal and non-fatal stroke, myocardial infarction, sudden cardiac death, heart failure, TIA, myocardial revascularization, de novo angina, carotid stenting or atrial fibrillation (AF) were adjudicated as incident CV events.
565 (10%) patients exhibited dilated initial eLAVI. During a median follow-up of 49 months, 233 patients developed CV events. Multivariable Cox regression analysis, demonstrated that dilated eLAVI increased risk of incident composite CV events (HR 1.90, 95%CI 1.26–2.88, p = 0.002), independently of significant effect of older age, male sex, presence LVH and carotid plaque.
Conclusions
In middle aged, treated hypertensive patients, dilated eLAVI is associated with adverse CV risk profile and is a predictor of CV events independently of other markers of TOD. LA dilatation should be considered as a TOD.
•LA dilatation is a strong predictor of worse outcome in young to middle age patients with hypertension even when AF development is excluded as end point.•In the setting of young to middle age patients with well controlled BP during follow-up, LA dilatation is the only CV ultrasound parameter capable to predict worse prognosis.•Consistent with previous studies, presence of dilated eLAVI was associated with a worse clinical CV risk profile, in particular higher prevalence of associated CV target organ damage.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>29628278</pmid><doi>10.1016/j.ijcard.2018.03.120</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-0308-2836</orcidid><orcidid>https://orcid.org/0000-0001-8567-9881</orcidid><orcidid>https://orcid.org/0000-0002-0701-6449</orcidid><orcidid>https://orcid.org/0000-0001-6690-1408</orcidid></addata></record> |
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| subjects | Adult Age Factors Atrial Function, Left - physiology Carotid plaque CV outcome Diastolic function Female Follow-Up Studies Heart Atria - diagnostic imaging Heart Atria - physiopathology Humans Hypertension - diagnostic imaging Hypertension - epidemiology Hypertension - physiopathology Intima media thickness Male Middle Aged Organ Size Registries Ventricular hypertrophy |
| title | Left atrial dilatation: A target organ damage in young to middle-age hypertensive patients. The Campania Salute Network |
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