Relationship of the total atrial conduction time to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus

Abstract

OBJECTIVES:The aim of our study was to evaluate the total atrial conduction time and its relationship to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus.METHODS:A total of 132 patients with type 2 diabetes mellitus (mean age 54.5±9.6 years; 57.6% male) and 80 age- and gender-matched controls were evaluated. The total atrial conduction time was measured by tissue-Doppler imaging and the carotid intima-media thickness was measured by B-mode ultrasonography.RESULTS:The total atrial conduction time was significantly longer in the patients with type 2 diabetes mellitus than in the control group (131.7±23.6 vs. 113.1±21.3, p<0.001). The patients with type 2 diabetes mellitus had significantly increased carotid intima-media thicknesses, neutrophil to lymphocyte ratios and high-sensitivity C-reactive protein levels than those of the controls. The total atrial conduction time was positively correlated with the high-sensitivity C-reactive protein level, neutrophil to lymphocyte ratio, carotid intima-media thickness and left atrial volume index and negatively correlated with the early diastolic velocity (Em), Em/late diastolic velocity (Am) ratio and global peak left atrial longitudinal strain. A multiple logistic regression analysis demonstrated that the neutrophil to lymphocyte ratio, carotid intima-media thickness and global peak left atrial longitudinal strain were independent predictors of the total atrial conduction time.CONCLUSIONS:We suggest that subclinical atherosclerosis and inflammation may represent a mechanism related to prolonged total atrial conduction time and that prolonged total atrial conduction time and impaired left atrial myocardial deformation may be represent early subclinical cardiac involvement in patients with type 2 diabetes mellitus.

Atrial electromechanical delay is impaired in patients with primary hyperparathyroidism

“…Roshanalli et al showed that the atrial electromechanical interval is a predictor of AF developing after coronary artery bypass grafting, and preoperative administration of amiodarone to patients with a longer atrial electromechanical interval reduces the incidence of postoperative AF [19]. Previous studies have shown that atrial EMD is prolonged in many clinical disorders such as mitral stenosis, diabetes mellitus, hypertension, psoriasis, and inflammatory bowel disease [20][21][22][23][24]. Also, the incidence of AF in these diseases has increased significantly compared to the normal population.…”

Atrial Electromechanical Delay Is Impaired in Patients with Primary Hyperparathyroidism

“…Roshanalli et al showed that the atrial electromechanical interval is a predictor of AF developing after coronary artery bypass grafting, and preoperative administration of amiodarone to patients with a longer atrial electromechanical interval reduces the incidence of postoperative AF (19). In addition, it has been shown in previous studies that atrial EMD is prolonged in many clinical disorders such as mitral stenosis, diabetes mellitus, hypertension, psoriasis, and Inflammatory Bowel Disease (20)(21)(22)(23)(24). In addition, the incidence of AF in these diseases has increased significantly compared to the normal population.…”

Clinical and prognostic association of total atrial conduction time in patients with heart failure: a report from Studies Investigating Co-morbidities Aggravating Heart Failure

“…Although they were asymptomatic and the vast majority was free of clinical congestion, some were treated with loop diuretic and, had they been breathless, would have fulfilled our criteria for a diagnosis of HFpEF, a difficult diagnosis to make (22)(23)(24). Moreover, many of the controls suffered from hypertension and/or type II diabetes, two common comorbidities that might increase the risk of heart failure (22), atrial fibrillation and prolong the P-A´TDI interval (25): is possible that P-A´TDI interval might be shorter in individuals who are entirely free of cardiovascular risk factors. In those without HF, those with DM had a longer lateral, but not septal, P-A´TDI interval than those without DM (septal P-A´TDI: DM -99 (21) ms, no DM: 90 (18) ms, p=0.078; lateral P-A´TDI: DM -121 (22) ms, no DM: 109 (22) ms, p=0.026).…”