Left atrial volume indexed for height is a new sensitive marker for subclinical cardiac organ damage in female hypertensive patients.

Left atrial enlargement (LAe) is a subclinical marker of hypertensive-mediated organ damage, which is important to identify in cardiovascular risk stratification. Recently, LA indexing for height was suggested as a more accurate marker of defining LAe. Our aim was to test the difference in LAe prevalence using body surface area (BSA) and height definitions in an essential hypertensive population. A total of 441 essential hypertensive patients underwent complete clinical and echocardiographic evaluation. Left atrial volume (LAV), left ventricular morphology, and systolic-diastolic function were evaluated. LAe was twice as prevalent when defined using height (LAe) indexation rather than BSA (LAe) (51% vs. 23%, p < 0.001). LAe, but not LAe, was more prevalent in females (p < 0.001). Males and females also differed in left ventricular hypertrophy (p = 0.046) and left ventricular diastolic dysfunction (LVDD) indexes (septal Em/Etdi: p = 0.009; lateral Em/Etdi: p = 0.003; mean Em/Etdi: p < 0.002). All patients presenting LAe also met the criteria for LAe. According to the presence/absence of LAe, we created three groups (Norm = BSA-/h-; DilH = BSA-/h+; DilHB = BSA+/h+). The female sex prevalence in the DilH group was higher than that in the other two groups (Norm: p < 0.001; DilHB: p = 0.036). LVH and mean and septal Em/Etdi increased from the Norm to the DilH group and from the DilH to the DilHB group (p < 0.05 for all comparisons). These results show that LAe identified twice as many patients as comparing LAe to LAe, but that both LAe and LAe definitions were associated with LVH and LVDD. In female patients, the LAe definition and its sex-specific threshold seem to be more sensitive than LAe in identifying chamber enlargement.