الفهرس 
Acknowledgments
Prevalence and burden of disease:Only 14 pages are availabe for public view
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Abstract
Hypertension is a main cause of HF with preserved ejection fraction (HFpEF) or ’diastolic heart failure’. It is associated with marked increases in morbidity and all-cause mortality. The preclinical phase of HF is characterized by the presence of structural and/or functional cardiac abnormalities including left atrial remodeling. It occurs as a physiologic response to pressure overload in hypertensive patients. LA volume reflects an average effect of LV filling pressures over time. The purpose of this study was to evaluate the relation between Left atrial volume index and diastolic dysfunction in hypertensive patients.
Our study population comprised a group of 60 hypertensive patients and a group of 30 healthy controls. Hypertensive patients were chosen after exclusion of ischemic, valvular, congenital heart disease, arrhythmias, permanent pacemakers and other non-cardiac causes of diastolic dysfunction. Diastolic dysfunction was assessed by echocardiography using E/A ratio, tissue Doppler values (septal and lateral e’,a’), E/e’, DT and IVRT. Left atrial volume was assessed using biplane area method.
The study participants were 60 hypertensive patients, (mean age 50.77±10.79 years) and 30 normotensive subjects (mean age32.6±11.06 years). In the hypertensive group, 25% were diabetics, 11.7% were smokers and 55% had positive family history for hypertension. Diastolic dysfunction was distributed as 51.67% normal, 11.67 % grade 1, 36.7%grade 2, 0%grade 3. Age, E/A and E/e’ were found to be predictors of increased LAVI. Correlation between left atrial volume and diastolic dysfunction was significant at the 0.01 level. R= 0.715. LAVI showed 86% sensitivity and 98% specificity for detection of diastolic dysfunction with cutoff at 33 with a 95% confidence interval. Area under the curve =0.928.
LAVI increases along with the progression of diastolic dysfunction. It is a feasible method for assessment of diastolic dysfunction. LAVI correlates to severity of diastolic dysfunction.