Anastase Dzudie Tamdja ^{1, 2, 3, 8} Corrine Armelle Simo Gounoue ^2,8  Simeon-Pierre Choukem ^{2, 3} Sidick Mouliom Aboubakar ³ Archange Nzali⁴  Marie Patrice Halle³  Clovis Nkoke⁵  Christ Nadege Nganou¹ Benjamin Momo Kadia⁶ Martin Hongieh Abanda⁷ Samuel Kingue¹

Authors’ affiliations

1. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
2. Faculty of Health Sciences, University of Buea, Buea, Cameroon
3. Douala General Hospital, Douala, Cameroon
4. Deido District Hospital, Douala, Cameroon
5. Buea Regional Hospital, Buea, Cameroon
6. Foumbot District Hospital, Foumbot, Cameroon.
7. Grace Community Health and Development Association, Kumba, Cameroon
8. Clinical Research Education, Networking and Consultancy, Douala, Cameroon

Corresponding author: Corrine Armelle Simo Gounoue: Clinical Research Education, Networking and Consultancy, Telephone: +23697698485 Email: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Abstract

Background: Left atrial remodelling (LAR) is a common finding in patients with chronic hypertension and increases the risk of adverse cardiovascular events. However in black Africans with hypertension, the early structural changes in the left atrial size and its associated factors have been poorly elucidated.

Objective: To assess left atrial structural remodelling and its determinants in hypertensive patients of black ethnicity

Methodology: This was a comparative cross-sectional study conducted in two hospitals in Douala from January to March 2017. Fifty-two patients either newly diagnosed with hypertension or known hypertensive treated for less than a year were enrolled through consecutive sampling and matched for age and sex to forty randomly selected healthy controls. Patients with pre-existing, cardiovascular disease, kidney disease and diabetes were excluded. The diameters of the left atrium were measured using standardized echocardiographic methods. Early morning urine was analyzed for microalbuminuria using urine strips.

Results: The hypertensive patients and controls were comparable for age and sex. Hypertensive patients had significantly higher body mass indices, Left ventricular mass (LVM) and an altered diastolic function. Patients with hypertension had a significantly higher left atrial longitudinal diameter (50.0mm versus 47.4mm, p=0.045), surface area (17.9cm² versus 15.5cm², p= 0.003) and volume (52.4ml versus 43.8ml, p=0.002). Fourteen hypertensive patients (26.9%) had left atrial enlargement compared to 1(2.5%) in control group. Diastolic dysfunction (p=0.008) was the only independent predictor of LA volume and LA enlargement. There was no correlation between microalbuminuria and left atrial size.

Conclusion: A significant proportion of black hypertensive patients had left atrial remodelling. The changes were characterised by an increase in the left atrial length, surface area and volume. Diastolic dysfunction was the only determinant of left atrial size in hypertensive patients

Key words: Hypertension, left atrium, remodelling, SSA