{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:10:06Z","timestamp":1788487806178,"version":"build-2803163510"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,2,2]]},"abstract":"\n Background<\/jats:title>\n \n Impaired left atrial (\n LA<\/jats:styled-content>\n ) 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\n LA<\/jats:styled-content>\n function.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We studied 212 subjects with hypertension and without heart failure or atrial fibrillation.\n LA<\/jats:styled-content>\n strain was measured from cine steady\u2010state free\u2010precession cardiac\n MRI<\/jats:styled-content>\n images using feature\u2010tracking algorithms. In multivariable models adjusted for age, sex, race, body mass index, blood pressure, diabetes mellitus,\n LA<\/jats:styled-content>\n volume, left ventricular mass, and left ventricular ejection fraction, beta\u2010blocker use was associated with a lower total longitudinal strain (standardized \u03b2=\u22120.21;\n P<\/jats:italic>\n =0.008), and lower\n LA<\/jats:styled-content>\n expansion index (standardized \u03b2=\u22120.30;\n P<\/jats:italic>\n <0.001), indicating impaired\n LA<\/jats:styled-content>\n reservoir function. Beta\u2010blocker use was also associated with a lower positive strain (standardized \u03b2=\u22120.19;\n P<\/jats:italic>\n =0.012) and early diastolic strain rate (standardized \u03b2=0.15;\n P<\/jats:italic>\n =0.039), indicating impaired\n LA<\/jats:styled-content>\n conduit function. Finally, beta\u2010blocker use was associated with a lower (less negative) late\u2010diastolic strain (standardized \u03b2=0.15;\n P<\/jats:italic>\n =0.049), strain rate (standardized \u03b2=0.18;\n P<\/jats:italic>\n =0.019), and a lower active\n LA<\/jats:styled-content>\n emptying fraction (standardized \u03b2=\u22120.27;\n P<\/jats:italic>\n <0.001), indicating impaired booster pump function. Use of other antihypertensive agents was not associated with\n LA<\/jats:styled-content>\n function.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Beta\u2010blocker use is significantly associated with impaired\n LA<\/jats:styled-content>\n function in hypertension. This association could underlie the increased risk of atrial fibrillation and stroke seen with the use of beta\u2010blockers (as opposed to other antihypertensive agents) demonstrated in recent trials.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.005163","type":"journal-article","created":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T20:10:44Z","timestamp":1486152644000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Beta\u2010Blocker Use Is Associated With Impaired Left Atrial Function in Hypertension"],"prefix":"10.1161","volume":"6","author":[{"given":"Mayank","family":"Sardana","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer Ahmed","family":"Syed","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeba","family":"Hashmath","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy S.","family":"Phan","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maheswara R.","family":"Koppula","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Kewan","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoubair","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravikantha","family":"Chandamuri","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapna","family":"Varakantam","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ejaz","family":"Shah","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Gorz","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Akers","sequence":"additional","affiliation":[{"name":"Corporal Michael J. 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