Relation of presence and severity of metabolic syndrome with left atrial mechanics in patients without overt diabetes: a deformation imaging study

Abstract

Objective: We aimed to investigate left atrium (LA) function by speckle tracking echocardiography in patients with metabolic syndrome (MetSyn) and to show a possible relationship between the severity of MetSyn and LA function and to determine the predictors of low strain in MetSyn patients. Methods: Our study design was observational and cross-sectional design consisted of 80 MetSyn patients without overt diabetes and 50 controls. The patients were classified into three groups based on the number of MetSyn criteria. The peak LA strain at the end of the ventricular systole (LAs-strain) as well as the LA strain with LA contraction (LAa-strain) was obtained. Correlation analysis performed to assess the association of LA strain parameters with the severity of MetSyn and logistic regression analysis performed to assess the relationship of low LA strain with MetSyn. Results: Both LAs (37.5±8.7 vs. 26.0±10.2, p<0.001) and LAa (19.9±6.3 vs. 13.0±6.4, p<0.001) strain measurements were found to be significantly decreased in patients with MetSyn when compared to the control group. Moreover, both LAs and LAa were found to be significantly decreased with the increasing severity of the MetSyn. A multiple logistic regression analysis demonstrated that the presence of MetSyn [OR:0.26 (95% CI 0.06-0.89), p=0.032] and left ventricular ejection fraction [OR:1.14 (95% CI 1.03-1.27), p=0.021] were independent predictors of LAs strain. Conclusion: MetSyn is associated with reduced LAs strain and LAa strain representing LA reservoir and pump function, respectively. Furthermore, LA mechanical function decreases even more with the increasing severity of the MetSyn.

The association between heart rate variability and biatrial phasic function in arterial hypertension

“…Interestingly, Kurt et al showed that metabolic syndrome was independently associated with decreased LA strain, whereas individual criteria were not proven to be the independent predictors of reduced LA strain. 32 In the whole study population, we did not find any relation between atrial phasic function and 24-hour heart rate, which is line with findings from the literature, 30 and in our case could be explained by a relatively small-normal range of 24-hour heart rate values that is perhaps responsible for the lack of statistically significant results. Decreased LA strain in our investigation is clinically very important because recent studies demonstrated that LA strain and strain rates represent independent predictors of stroke, transitory ischemic attack, and heart failure in patients with atrial fibrillation that is usually associated with hypertension.…”

Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation

“…Speckle-tracking echocardiography (STE) is a non-Doppler, angle-independent technique allowing the measurement of global and regional atrial strain (6, 17). Several studies have already proved the usefulness of LA STE in sinus rhythm (12, 18) and in AF (19, 20).…”

Assessment of Left Atrial Mechanics in Patients with Preexcitation Syndrome Scheduled for Catheter Ablation

“…15 The evaluation of LA function with two-dimensional strain imaging has only recently been proposed. 1,3,[16][17][18] There are two different strain values used in the evaluation of LA functions by strain imaging: the peak strain at LA reservoir phase and the strain value measured just before the P-wave at LA pump function phase. 19 LA reservoir functions are mainly determined by LV-systolic functions and LA stiffness.…”