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dc.contributor.authorSardana, Mayank
dc.contributor.authorSyed, Amer Ahmed
dc.contributor.authorHashmath, Zeba
dc.contributor.authorPhan, Timothy S.
dc.contributor.authorKoppula, Maheswara R.
dc.contributor.authorKewan, Uzma
dc.contributor.authorAhmed, Zoubair
dc.contributor.authorChandamuri, Ravikantha
dc.contributor.authorVarakantam, Swapna
dc.contributor.authorShah, Ejaz
dc.contributor.authorGorz, Ryan
dc.contributor.authorAkers, Scott R.
dc.contributor.authorChirinos, Julio A.
dc.date2022-08-11T08:09:47.000
dc.date.accessioned2022-08-23T16:43:27Z
dc.date.available2022-08-23T16:43:27Z
dc.date.issued2017-02-03
dc.date.submitted2017-06-21
dc.identifier.citationJ Am Heart Assoc. 2017 Feb 3;6(2). pii: e005163. doi: 10.1161/JAHA.116.005163. <a href="https://doi.org/10.1161/JAHA.116.005163">Link to article on publisher's site</a>
dc.identifier.issn2047-9980 (Linking)
dc.identifier.doi10.1161/JAHA.116.005163
dc.identifier.pmid28159822
dc.identifier.urihttp://hdl.handle.net/20.500.14038/40296
dc.description.abstractBACKGROUND: Impaired left atrial (LA) mechanical function is present in hypertension and likely contributes to various complications, including atrial arrhythmias, stroke, and heart failure. Various antihypertensive drug classes exert differential effects on central hemodynamics and left ventricular function. However, little is known about their effects on LA function. METHODS AND RESULTS: We studied 212 subjects with hypertension and without heart failure or atrial fibrillation. LA strain was measured from cine steady-state free-precession cardiac MRI images using feature-tracking algorithms. In multivariable models adjusted for age, sex, race, body mass index, blood pressure, diabetes mellitus, LA volume, left ventricular mass, and left ventricular ejection fraction, beta-blocker use was associated with a lower total longitudinal strain (standardized beta=-0.21; P=0.008), and lower LA expansion index (standardized beta=-0.30; P < 0.001), indicating impaired LA reservoir function. Beta-blocker use was also associated with a lower positive strain (standardized beta=-0.19; P=0.012) and early diastolic strain rate (standardized beta=0.15; P=0.039), indicating impaired LA conduit function. Finally, beta-blocker use was associated with a lower (less negative) late-diastolic strain (standardized beta=0.15; P=0.049), strain rate (standardized beta=0.18; P=0.019), and a lower active LA emptying fraction (standardized beta=-0.27; P< 0.001), indicating impaired booster pump function. Use of other antihypertensive agents was not associated with LA function. CONCLUSIONS: Beta-blocker use is significantly associated with impaired LA function in hypertension. This association could underlie the increased risk of atrial fibrillation and stroke seen with the use of beta-blockers (as opposed to other antihypertensive agents) demonstrated in recent trials.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=28159822&dopt=Abstract">Link to Article in PubMed</a>
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectangiotensin‐converting enzyme inhibitors
dc.subjecthypertension
dc.subjectleft atrium
dc.subjectmagnetic resonance imaging
dc.subjectβ‐adrenergic antagonists
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.titleBeta-Blocker Use Is Associated With Impaired Left Atrial Function in Hypertension
dc.typeJournal Article
dc.source.journaltitleJournal of the American Heart Association
dc.source.volume6
dc.source.issue2
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=4103&amp;context=oapubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/3098
dc.identifier.contextkey10331031
refterms.dateFOA2022-08-23T16:43:27Z
html.description.abstract<p>BACKGROUND: Impaired left atrial (LA) mechanical function is present in hypertension and likely contributes to various complications, including atrial arrhythmias, stroke, and heart failure. Various antihypertensive drug classes exert differential effects on central hemodynamics and left ventricular function. However, little is known about their effects on LA function.</p> <p>METHODS AND RESULTS: We studied 212 subjects with hypertension and without heart failure or atrial fibrillation. LA strain was measured from cine steady-state free-precession cardiac MRI images using feature-tracking algorithms. In multivariable models adjusted for age, sex, race, body mass index, blood pressure, diabetes mellitus, LA volume, left ventricular mass, and left ventricular ejection fraction, beta-blocker use was associated with a lower total longitudinal strain (standardized beta=-0.21; P=0.008), and lower LA expansion index (standardized beta=-0.30; P < 0.001), indicating impaired LA reservoir function. Beta-blocker use was also associated with a lower positive strain (standardized beta=-0.19; P=0.012) and early diastolic strain rate (standardized beta=0.15; P=0.039), indicating impaired LA conduit function. Finally, beta-blocker use was associated with a lower (less negative) late-diastolic strain (standardized beta=0.15; P=0.049), strain rate (standardized beta=0.18; P=0.019), and a lower active LA emptying fraction (standardized beta=-0.27; P< 0.001), indicating impaired booster pump function. Use of other antihypertensive agents was not associated with LA function.</p> <p>CONCLUSIONS: Beta-blocker use is significantly associated with impaired LA function in hypertension. This association could underlie the increased risk of atrial fibrillation and stroke seen with the use of beta-blockers (as opposed to other antihypertensive agents) demonstrated in recent trials.</p>
dc.identifier.submissionpathoapubs/3098
dc.contributor.departmentDivision of Cardiovascular Medicine, Department of Medicine


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