Unit:
Κατεύθυνση Αρτηριακή Υπέρταση και Συνοδά Καρδιαγγειακά-Νεφρικά ΝοσήματαLibrary of the School of Health Sciences
Author:
Paraskevopoulou Dimitra
Supervisors info:
Κωνσταντίνος Τσιούφης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Αγγέλη Κωνσταντίνα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σιάσος Γεράσιμος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ο αριστερός κόλπος στην υπέρταση (επιδημιολογία-παθοφυσιολογία-εκτίμηση δομικών και λειτουργικών μεταβολών και κλινική έκβαση αυτών) (ανασκόπηση)
Translated title:
Left atrial in hypertension (epidemiology-pathophysiology- evaluation of structural and functional changes and their clinical outcome) (review)
Summary:
The left atrial is one of the four cavities of the heart. It is a dynamic part with mechanical electrical and secreting action. The enlargement of the left atrial is a common finding for hypertensive patients and the size of the enlargement is related to the duration of the hypertension and the levels of systolic pressure as well as to various demographic, clinical and echocardiographic covariates.
The left atrial through its three functions (conduit function, reservoir function and pump function) forms the left ventricle filling. In hypertensive patients the size of left atrial is increased and this is an early sign of hypertensive cardiomyopathy. The enlargement of left ventricle, which is the main symptom of hypertensive cardiomyopathy, through a sequence of events drives to the enlargement of the left atrial which can be a cause of atrial fibrillation. A very important role in the pathophysiology of the left atrial seems to play the chronic activation of the renin-angiotensin-aldosterone system while in hypertensive patients high levels of BNP are found.
The left atrial is studied by a couple of invasive and non-invasive methods depending on the goal and the availability. The method of choice for the study of the heart cavities, from a functional and anatomical perspective, is cardiac MRI. However, the most used one, in the daily clinical practice is the transthoracic echocardiography. The left atrial is a useful clinical index for the cardiac remodelling in hypertension and a useful clinical prognostic factor for the cardiovascular risk, while the anti-hypertension therapy with medicines which inhibit the axis renin-angiotensin-aldosterone and thiazide diuretics seems to act beneficially and to lead to the inversion of the left atrial’s remodelling.
Main subject category:
Health Sciences
Keywords:
Hypertension, Left atrial, Left atrial enlargement
File:
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Paraskevopoulou_Dimitra_MSc.pdf
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