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Left atrial strain predicts cardiovascular response to exercise in young adults with suboptimal blood pressure
Author(s) -
Alsharqi Maryam,
Huckstep Odaro J.,
Lapidaire Winok,
Williamson Wilby,
Mohamed Afifah,
Tan Cheryl M.J.,
Kitt Jamie,
Burchert Holger,
Telles Fernando,
Dawes Helen,
Foster Charlie,
Lewandowski Adam J.,
Leeson Paul
Publication year - 2021
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.15149
Subject(s) - cardiology , medicine , ejection fraction , blood pressure , left ventricular hypertrophy , stroke volume , diastole , subclinical infection , heart rate , heart failure
Aims To investigate the left ventricular response to exercise in young adults with hypertension, and identify whether this response can be predicted from changes in left atrial function at rest. Methods A total of 127 adults aged 18–40 years who completed clinical blood pressure assessment and echocardiography phenotyping at rest and during cardiopulmonary exercise testing, were included. Measurements were compared between participants with suboptimal blood pressure ≥120/80mm Hg ( n = 68) and optimal blood pressure <120/80mm Hg ( n = 59). Left ventricular systolic function during exercise was obtained from an apical four chamber view, while resting left atrial function was assessed from apical four and two chamber views. Results Participants with suboptimal blood pressure had higher left ventricular mass ( p = 0.031) and reduced mitral E velocity ( p = 0.02) at rest but no other cardiac differences. During exercise, their rise in left ventricular ejection fraction was reduced ( p = 0.001) and they had higher left ventricular end diastolic and systolic volumes ( p = 0.001 and p = 0.001, respectively). Resting cardiac size predicted left ventricular volumes during exercise but only left atrial booster pump function predicted the left ventricular ejection fraction response ( β= .29, p = 0.011). This association persisted after a djustment for age, sex, body mass index, and mean arterial pressure. Conclusion Young adults with suboptimal blood pressure have a reduced left ventricular systolic response to exercise, which can be predicted by their left atrial booster pump function at rest. Echocardiographic measures of left atrial function may provide an early marker of functionally relevant, subclinical, cardiac remodelling in young adults with hypertension.