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Association between left atrial stiffness and aortic plaque thickness in hypertensive patients with stroke
Author(s) -
Mahfouz Ragab A.,
Galal Islam,
Ghareb Mohamed S.,
Abdelghafar Adel S.
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13877
Subject(s) - medicine , cardiology , stroke (engine) , atrial fibrillation , receiver operating characteristic , mechanical engineering , engineering
Objective Our aim was to investigate the relation between left atrial stiffness ( LAS t) and thoracic aortic plaque thickness in hypertensive patients with stroke. Method A total of 97 hypertensive patients were recruited (age: 59.2 ± 7.5 years), including 56 consecutive patients with undefined stroke and 41 age‐matched hypertensive patients without stroke. Left atrial strain and stiffness were measured using speckle tracking echo. Thoracic aortic plaque detection and evaluation was performed using transesophageal echocardiography. Results Hypertensive patients with stroke, when compared with those without stroke, had a significantly higher LAS t value ( P < .001). The percentage of plaque 1–4 mm thickness were comparable in both groups (23.2% vs 21.9%; P > .05). While the percentage of plaque ≥4 mm thickness was much higher in hypertensive patients with stroke (71.4% vs 4.9%; P < .001). LAS t was considerably increased in hypertensive group with paroxysmal atrial fibrillation ( PAF ) when compared to hypertensive group without PAF ( P < .01). A significant positive correlation was found between the LAS t and plaque thickness ( P < .001). Multivariate analysis showed that LAS t was the strongest independent predictor for ≥4 mm aortic plaque thickness (Hazard ratio = 6.153; P < .001). With receiver operating characteristic ( ROC ) curve analysis, LAS t > 0.63 was the best cutoff value in predicting aortic plaque thickness ≥ 4 mm. Conclusion Left atrial stiffness was significantly associated with aortic plaque thickness ≥ 4 mm, in hypertensive patients with stroke. These finding prevailed the importance of LAS t in risk stratification of hypertension.