The influence of white-coat hypertension on left atrial phasic function

Figures & data

Table 1. Demographic characteristics and clinical parameters of study population.

	Normal BP(n= 52)	WCH(n= 49)	HTN(n= 56)	p
Age (years)	48 ± 7	50 ± 7	51 ± 7	0.080
Female (%)	25 (48)	22 (45)	25 (45)	0.556
BMI (kg/m^2)	24.6 ± 2.4	25.2 ± 2.2	26.0 ± 2.6^a	0.012
BSA (m^2)	1.88 ± 0.11	1.93 ± 0.12	1.96 ± 0.12^a	0.002
Heart rate (beats/min)	69 ± 6	71 ± 7	72 ± 8	0.086
Clinic systolic BP (mmHg)	120 ± 9	148 ± 8^a	150 ± 10^a	<0.001
Clinic diastolic BP (mmHg)	71 ± 7	93 ± 7^a	95 ± 7^a	<0.001
Pulse pressure (mmHg)	39 ± 4	54 ± 6^a	55 ± 7^a	<0.001
Plasma glucose (mmol/l)	4.9 ± 0.6	4.9 ± 0.7	5.1 ± 0.8	0.240
Triglycerides (mmol/l)	1.6 ± 0.3	1.6 ± 0.3	1.9 ± 0.4^a^,^b	<0.001
Total cholesterol (mmol/l)	5.0 ± 0.5	5.1 ± 0.5	5.2 ± 0.6	0.159
Serum creatinine (μmol/l)	79 ± 9	78 ± 8	79 ± 8	0.784

BMI: body mass index; BP: blood pressure; HTN: hypertension; WCH: white-coat hypertension.

^ap < 0.01 versus normal BP.

^bp < 0.01 versus WCH.

Table 2. Twenty-four hour blood pressure monitoring parameters of study population.

	Normal BP(n= 52)	WCH(n= 49)	HTN(n= 56)	p
24-h systolic BP (mmHg)	117 ± 7	118 ± 6	138 ± 8^a^,^b	<0.001
24-h diastolic BP (mmHg)	68 ± 6	67 ± 5	86 ± 7^a^,^b	<0.001
24-h mean BP (mmHg)	84 ± 7	84 ± 7	103 ± 8^a^,^b	<0.001
Pulse pressure (mmHg)	48 ± 5	51 ± 5^c	53 ± 6^a	<0.001
Daytime systolic BP (mmHg)	120 ± 8	121 ± 7	142 ± 9^a^,^b	<0.001
Daytime diastolic BP (mmHg)	70 ± 7	69 ± 7	90 ± 8^a^,^b	<0.001
Daytime mean BP (mmHg)	87 ± 8	86 ± 8	107 ± 8^a^,^b	<0.001
Nighttime systolic BP (mmHg)	108 ± 7	109 ± 6	126 ± 7^a^,^b	<0.001
Nighttime diastolic BP (mmHg)	62 ± 6	61 ± 5	74 ± 6^a^,^b	<0.001
Nighttime mean BP (mmHg)	77 ± 7	77 ± 6	91 ± 7^a^,^b	<0.001

BP: blood pressure.

^ap < 0.01 versus normal BP.

^bp < 0.01 versus WCH.

^cp < 0.05 versus normal BP.

Table 3. Echocardiographic parameters of left ventricular structure and function in the study population (adjusted for BMI).

	Normal BP(n= 52)	WCH(n= 49)	HTN(n= 56)	p
LV EDD (mm)	48.4 ± 4.3	48.8 ± 4.5	49.4 ± 4.7	0.508
LV ESD (mm)	30.2 ± 3.3	30.4 ± 3.4	31.6 ± 3.8	0.085
IVS (mm)	9.2 ± 1	9.7 ± 1.2	10.6 ± 1.3^a^,^b	<0.001
PWT (mm)	9.0 ± 1	9.4 ± 1.1	10.5 ± 1.2^a^,^b	<0.001
RWT	0.37 ± 0.02	0.39 ± 0.03	0.43 ± 0.03	<0.001^c
LVMI (g/m^2)	81 ± 7.4	86 ± 8.6	98 ± 11	<0.001^d
LV EF (%)	64 ± 3	64 ± 3	63 ± 4	0.216
E/A ratio	1.20 ± 0.25	1.07 ± 0.21	0.92 ± 0.22	<0.001^d
E/e′ ratio	6.5 ± 2.0	8.0 ± 2.1	9.4 ± 2.3	<0.001^c

A: late diastolic mitral flow (pulse Doppler); DT: deceleration time; E: early diastolic mitral flow (pulsed Doppler); e′: average of the peak early diastolic relaxation velocity of the septal and lateral mitral annulus (tissue Doppler); EF: ejection fraction; IVS: interventricular septum; LVMI: left ventricular mass index; LVEDD: left ventricle end-diastolic dimension; PWT: posterior wall thickness; RWT: relative wall thickness; WCH: white-coat hypertension.

^ap < 0.01 versus normal BP.

^bp < 0.01 versus WCH.

^cp < 0.01 for all comparisons.

^dp < 0.05 for all comparisons.

Table 4. Left atrial phasic function assessed by volumetric and strain methods in the study population (strain parameters were adjusted for BMI).

	Normal BP(n= 52)	WCH(n= 49)	HTN(n= 56)	p
LA volume analysis
LAVmax (ml)	53.0 ± 6.0	59.4 ± 7.0	64.5 ± 8.2	<0.001^c
LAVmax/BSA (ml/m^2)	28.2 ± 3.2	30.8 ± 3.6	32.9 ± 4.2	<0.001^d
LAVmin (ml)	21.2 ± 3.7	24.9 ± 3.9	28.4 ± 4.4	<0.001^c
LAVmin/BSA (ml/m^2)	11.3 ± 2.3	12.9 ± 2.5	14.5 ± 3.1	<0.001^c
LAVpre-a (ml)	30.7 ± 5.1	38.3 ± 5.9	45.1 ± 7.0	<0.001^c
LAVpre-a/BSA (ml/m^2)	16.3 ± 2.8	19.8 ± 3.1	23.0 ± 3.7	<0.001^c
LA TotEV (ml)	31.8 ± 5.7	34.5 ± 5.9	36.1 ± 6.5^a	0.001
LA PassEV (ml)	22.3 ± 4.2	21.1 ± 4.0	19.4 ± 4.1^a	0.001
LA ActEV (ml)	9.5 ± 2.7	13.4 ± 3.3	16.7 ± 4.3	<0.001^c
LA TotEF (%)	60 ± 6	58 ± 5	56 ± 4^b	<0.001
LA PassEF (%)	42 ± 5	36 ± 5	30 ± 4	<0.001^c
LA ActEF (%)	31 ± 4	35 ± 5^a	37 ± 5^a	<0.001
LA mechanics
Total longitudinal strain (%)	43 ± 6	40 ± 5	36 ± 4	<0.001^c
Positive longitudinal strain (%)	23 ± 5	18 ± 4	12 ± 3	<0.001^c
Negative longitudinal strain (%)	−20 ± 4	−22 ± 5	−24 ± 6^a	<0.001
LA stiffness index	0.15 ± 0.06	0.20 ± 0.07	0.26 ± 0.1	<0.001^c

ActEF: active emptying fraction; ActEV: active emptying volume; BP: blood pressure; HTA: hypertension; LAV_max: maximal left atrial volume; LAV_min: minimal left atrial volume; LAV_pre-a: left atrial volume before atrial contraction; LV: left ventricle; PassEF: passive emptying fraction; PassEV: passive emptying volume; TotEF: total emptying fraction; TotEV: total emptying volume; WCH: white: coat hypertension.

^ap < 0.01 versus normal BP.

^bp < 0.01 versus WCH.

^cp < 0.01 for all comparisons.

^dp < 0.05 for all comparisons.