Background: Lately, there has been a growing focus on structural and functional changes in the left atrium (LA), which may be early signs of heart damage brought on by hypertension (HTN). Speckle tracking echocardiography can detect a variety of myocardial fiber failure indicators. We aimed to use speckle tracking echocardiography in well controlled hypertensive patients with normal left atrial size for assessment of left atrial function.

Patients and methods: This study included 52 hypertensive patients for early detection of left atrial dysfunction even before left atrial enlargement and compared to 52 normal control subjects. The study population was subjected to complete history taking, full clinical examination, standard 12 leads electrocardiogram and echocardiography. LA stroke volume (LASV) and LA expansion index were calculated. Global peak atrial longitudinal strain, LV systolic function, and LV diastolic function were determined. The early diastolic E′ velocity and late diastolic A′ velocity were estimated by tissue Doppler imaging.

Results: There was a statistically significant difference between the two groups as regard DM and LV diastolic dysfunction; as diabetic patients had lower global PALS and patients with grade II diastolic dysfunction had lower global PALS. A negative correlation between global PALS and age, BMI, SBP, LVMI and LAVI, while there was a statistically significant positive correlation with LA expansion index.

Conclusion: Speckle tracking echocardiography is a helpful new method for identifying early LA malfunction in hypertension before LA enlargement happens.