Left and right atrial phasic function and deformation in untreated patients with prediabetes and type 2 diabetes mellitus

Abstract

To evaluate phasic function and deformation of the left atrium (LA) and right atrium (RA) in subjects with prediabetes and type 2 diabetes mellitus. This cross-sectional study included 50 untreated normotensive subjects with prediabetes, 60 recently diagnosed normotensive diabetic patients and 60 healthy controls of similar sex and age. All the subjects underwent laboratory analyses and complete echocardiographic examination including strain analysis. LA and RA reservoir and conduit function gradually decreased, while booster pump increased, from the healthy controls, throughout the prediabetics, to the diabetics. The strain analysis of atrial phasic function showed more regular pattern of progressive atrial function deterioration than conventional evaluation with total, active and passive atrial function. In the whole study population HbA1c correlated with LA passive emptying fraction (r = -0.38, p < 0.01), LA active emptying fraction (r = 0.36, p < 0.01), LA longitudinal strain during systole (r = -0.35, p < 0.01), RA passive emptying fraction (r = -0.42, p < 0.01), RA active emptying fraction (r = 0.38, p < 0.01), and RA longitudinal strain during systole (r = -0.32, p < 0.01). However, only LA passive emptying fraction (β = -0.32, p < 0.01) and LA longitudinal strain during systole (β = -0.28, p = 0.02) were independently associated with HbA1c among the LA parameters; whereas solely RA passive emptying fraction (β = -0.37, p < 0.01) and RA active emptying fraction (β = 0.31, p = 0.01) were independently associated with HbA1c among the RA parameters. LA and RA phasic functions are significantly impaired in the prediabetics and the diabetics. The parameter of glucose control correlated with LA and RA reservoir, conduit and pump atrial function.

Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography

“…LA conduit function is correlated with LV early diastolic function [29], LA reservoir function is correlated with LV systolic function [30, 31], and LA pump function is associated with LV late diastolic function [32, 33]. The result of our study had agreed to these above.…”

Type 1 diabetes mellitus and atrial function: A complex relationship

“…Acar et al did not report any difference in the 3DE LA total emptying volume; however, they detected increased active and decreased passive emptying fractions (7). Similar findings were reported from our research group (8). …”

“…In a prior study, Acar et al (7) did not show any difference in 3DE LA volume indices between type 1 DM patients and controls. Our study group reported that 3DE LA volumes were higher in subjects with type 2 DM; however, after adjustment for body size, these differences disappeared (8). …”

Type 2 diabetes mellitus and atrial fibrillation: From mechanisms to clinical practice

“…Findings from our group show that left and right atrial reservoir and conduit function, assessed by emptying fractions and strain, are decreased among subjects with prediabetes and patients with diabetes compared with controls [14]. On the other hand, left and right atrial pump function increased in the same direction.…”