Association between left atrial stiffness and aortic plaque thickness in hypertensive patients with stroke

作者：Mahfouz Ragab A^*; Galal Islam; Ghareb Mohamed S; Abdelghafar Adel S

来源：Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques, 2018, 35(7): 949-956.

DOI：10.1111/echo.13877

• aortic plaque
• hypertension
• left atrial stiffness
• stroke

ObjectiveOur aim was to investigate the relation between left atrial stiffness (LASt) and thoracic aortic plaque thickness in hypertensive patients with stroke.
MethodA total of 97 hypertensive patients were recruited (age: 59.27.5years), 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.
ResultsHypertensive patients with stroke, when compared with those without stroke, had a significantly higher LASt value (P<.001). The percentage of plaque 1-4mm thickness were comparable in both groups (23.2% vs 21.9%; P>.05). While the percentage of plaque 4mm thickness was much higher in hypertensive patients with stroke (71.4% vs 4.9%; P<.001). LASt 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 LASt and plaque thickness (P<.001). Multivariate analysis showed that LASt was the strongest independent predictor for 4mm aortic plaque thickness (Hazard ratio=6.153; P<.001). With receiver operating characteristic (ROC) curve analysis, LASt>0.63 was the best cutoff value in predicting aortic plaque thickness4mm.
ConclusionLeft atrial stiffness was significantly associated with aortic plaque thickness4mm, in hypertensive patients with stroke. These finding prevailed the importance of LASt in risk stratification of hypertension.

• 出版日期2018-7