Vol 8, No 2 (2004)
Editorial
Published online: 2004-04-06
Influence of arterial hypertension on left atrial structure and function
Małgorzata Prejbisz, Tomasz Pasierski
Nadciśnienie tętnicze 2004;8(2):81-87.
Vol 8, No 2 (2004)
Artykuły redakcyjne
Published online: 2004-04-06
Abstract
There has been a growing interest recently in the relationship between arterial hypertension and atrial fibrillation. The role of hypertension as risk factor for atrial fibrillation is established but still incompletely understood. Both hypertension and atrial fibrillation are independent risk factors of stroke, and among subjects with atrial fibrillation, hypertension increases the risk of stroke. In hypertensive patients the risk of atrial fibrillation is two-fold higher than in normotensives.
Hypertension can lead not only to the left ventricular hypertrophy but also to the increase of left atrial pressure and dilatation of the left atrium. This in consequence leads to
increased arhythmogenesis of the atrial myocardium. It has been demonstrated that angiotensin II and aldosterone, hormones regulating blood pressure levels, can cause fibrosis of
atria. Increased atrial fibrosis is basis for development of reentry
loop, which initiates and propagates atrial fibrillation. Those two hormones are also involved in electrical atrial remodeling - a process that causes new recurrences of atrial fibrillation after cardioversion and leads to chronic atrial fibrillation. Some classes of antihypertensive drugs, i.e. ACE
inhibitors, angiotensin receptor blockers and verapamil can inhibit these processes, that has been shown both in hypertensive and normotensive subjects. Prevention of the atrial
fibrillation should be used as a one of the criteria of antihypertensive
drugs efficacy.
Abstract
There has been a growing interest recently in the relationship between arterial hypertension and atrial fibrillation. The role of hypertension as risk factor for atrial fibrillation is established but still incompletely understood. Both hypertension and atrial fibrillation are independent risk factors of stroke, and among subjects with atrial fibrillation, hypertension increases the risk of stroke. In hypertensive patients the risk of atrial fibrillation is two-fold higher than in normotensives.
Hypertension can lead not only to the left ventricular hypertrophy but also to the increase of left atrial pressure and dilatation of the left atrium. This in consequence leads to
increased arhythmogenesis of the atrial myocardium. It has been demonstrated that angiotensin II and aldosterone, hormones regulating blood pressure levels, can cause fibrosis of
atria. Increased atrial fibrosis is basis for development of reentry
loop, which initiates and propagates atrial fibrillation. Those two hormones are also involved in electrical atrial remodeling - a process that causes new recurrences of atrial fibrillation after cardioversion and leads to chronic atrial fibrillation. Some classes of antihypertensive drugs, i.e. ACE
inhibitors, angiotensin receptor blockers and verapamil can inhibit these processes, that has been shown both in hypertensive and normotensive subjects. Prevention of the atrial
fibrillation should be used as a one of the criteria of antihypertensive
drugs efficacy.
Keywords
left atrium; atrial fibrillation; left ventricular diastolic function
Title
Influence of arterial hypertension on left atrial structure and function
Journal
Arterial Hypertension
Issue
Vol 8, No 2 (2004)
Article type
Editorial
Pages
81-87
Published online
2004-04-06
Page views
635
Article views/downloads
1377
Bibliographic record
Nadciśnienie tętnicze 2004;8(2):81-87.
Keywords
left atrium
atrial fibrillation
left ventricular diastolic function
Authors
Małgorzata Prejbisz
Tomasz Pasierski
About this article