Objective: To estimate the relationship between endothelial function and left atrial diameter in hypertensive patients with persistent atrial fibrillation (AF) in sinus rhythm maintenance.
Methods: The study included 50 hypertensive patients with persistent AF with mean age of 60.9±11.2 years, of them 19 women (38%) and 31 men (62%). Endothelial function in all the patients was evaluated by ultrasound assessment of endothelial-dependent flow-mediated vasodilation (FMD) of the brachial artery in response to reactive hyperemia measured in the early morning hours. Myocardial structure and function was assessed using echocardiography.
Results: Reduced %FMD change (< 10%) was found in 47 (94%) hypertensive patients with persistent AF, implying impaired endothelial function. The average increase in brachial artery diameter 60 seconds after decompression was 5.8 ± 0.9% in this group. All patients had normal left ventricular ejection fraction, end diastolic and systolic volume. We registered enlarged left atrial diameter (> 44 mm) in 45 (90%) patients. There was a strong negative direct correlation between left atrial diameter and endothelial-dependent vasodilation of brachial artery in the patients with persistent AF (r= -0.89, P<0.05).
Conclusion: A strong negative correlation between left atrial diameter and endothelial-dependent FMD was found in hypertensive patients with persistent AF.