Relationship between increased left atrial volume and microvascular complications in patients with type 2 diabetes

Bonapace, Stefano; Rossi, Andrea; Lipari, Paola; Bertolini, Lorenzo; Zenari, Luciano; Lanzoni, Laura; Canali, G; Molon, Giulio; Mantovani, Alessandro; Zoppini, Giacomo; Bonora, Enzo; Barbieri, Enrico; Targher, Giovanni

doi:10.1016/j.jdiacomp.2015.05.006

Cited by 12 publications

(5 citation statements)

References 43 publications

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“…Coronary flow reserve, which reflects coronary microvascular function, correlated independently with echocardiographic measures of LV diastolic dysfunction in diabetics without evidence of CAD [23] and the presence of microvascular disease correlated independently with LA volume [24]. In keeping with this, we found that baseline clinical evidence of microvascular disease in noncardiac vascular territories independently predicted HF-CVD.…”

Section: Discussionsupporting

confidence: 69%

Cardiac Computed Tomography Angiographic Findings as Predictors of Late Heart Failure in an Asymptomatic Diabetic Cohort: An 8-Year Prospective Follow-Up Study

Halon¹,

Jubran²,

Rubinshtein³

et al. 2017

Cardiology

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Objectives: Predictive models for heart failure (HF) in heterogeneous populations have had limited success. We examined cardiac computed tomography angiography (CTA) predictors of HF or cardiovascular death (HF-CVD) in a prospective study of asymptomatic diabetics undergoing baseline assessment by CTA. Methods: The subjects (n = 735, aged 55-74 years, 51.2% women) had no clinical history of cardiovascular disease at study entry. Coronary artery calcium (CAC) score, CTA-defined coronary atherosclerosis, cardiac chamber volumes, and clinical data were collected and late outcome events recorded over 8.4 ± 0.6 years (range 7.3-9.3). Results: HF-CVD occurred in 41 (5.6%) subjects, with HF occurring mostly (19/23, 82.6%) in subjects without preceding myocardial infarction. Baseline univariate clinical outcome predictors of HF-CVD included older age (p = 0.027), the duration of diabetes (p = 0.004), HbA1c (p < 0.0001), microvascular disease (retinopathy, microalbuminuria) (p < 0.0001), and systolic blood pressure (p = 0.035). Baseline univariate CTA predictors included CAC score (p = 0.004), coronary stenosis (p = 0.047), and a CTA-defined left/right atrial (LA/RA) volume ratio >1 (p < 0.0001). Independent predictors were an LA/RA volume ratio >1, microvascular disease, and systolic blood pressure (model C-statistic 0.792, 95% CI 0.758-0.824). Measures of the extent of coronary artery disease (CAD) were not independent predictors of HF-CVD. Conclusions: In a low- to moderate-risk asymptomatic diabetic population, CTA LA enlargement (LA/RA volume ratio) but not the extent of CAD had independent prognostic value for HF-CVD in addition to the clinical variables.

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Section: Discussionsupporting

confidence: 69%

Cardiac Computed Tomography Angiographic Findings as Predictors of Late Heart Failure in an Asymptomatic Diabetic Cohort: An 8-Year Prospective Follow-Up Study

Halon¹,

Jubran²,

Rubinshtein³

et al. 2017

Cardiology

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“…Based on these findings, our study further suggests that DR and microvascular heart disease are not completely separate. Microangiopathy may play an essential pathogenic role in developing cardiac dysfunction, or a common fundamental pathway exists among these disorders [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Severity of Diabetic Retinopathy and Cardiac Function in Patients with Type 2 Diabetes

Chen

Wang

et al. 2023

Journal of Diabetes Research

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Background. The purpose of this research was to assess the relationship between the severity of diabetic retinopathy (DR) and indexes of left ventricle (LV) structure and function in type 2 diabetes mellitus (T2DM). Methods. Retrospective analysis of 790 patients with T2DM and preserved LV ejection fraction. Retinopathy stages were classified as no DR, early nonproliferative DR, moderate to severe nonproliferative DR, or proliferative DR. The electrocardiogram was used to assess myocardial conduction function. Echocardiography was used to evaluate myocardial structure and function. Results. Patients were divided into three groups based on the DR status: no DR group (NDR, n = 475 ), nonproliferative DR group (NPDR, n = 247 ), and proliferative DR group (PDR, n = 68 ). LV interventricular septal thickness (IVST) increased significantly with more severe retinopathy (NDR: 10.00 ± 1.09 ; NPDR: 10.42 ± 1.21 ; and PDR: 10.66 ± 1.58 ; P < 0.001). Multivariate logistic regression analysis showed that the significant correlation of IVST persisted between subjects with no retinopathy and proliferative DR (odds ratio = 1.35 , P = 0.026 ). Indices of myocardial conduction function were assessed by electrocardiogram differences among groups of retinopathy (all P < 0.001 ). In multiple-adjusted linear regression analyses, the increasing degree of retinopathy was closely correlated with heart rate ( β = 1.593 , P = 0.027 ), PR interval ( β = 4.666 , P = 0.001 ), and QTc interval ( β = 8.807 , P = 0.005 ). Conclusion. The proliferative DR was independently associated with worse cardiac structure and function by echocardiography. Furthermore, the severity of retinopathy significantly correlated with abnormalities of the electrocardiogram in patients with T2DM.

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“…Despite the best efforts, diabetes leads to a decreased life expectancy of five to ten years [100] due to micro and macro complications caused by long-term hyperglycaemia and other risk factors [101], [102]. Quality of life is also impaired, especially when chronic micro and macrovascular complications develop [100].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Vascular Damage: Review of Pathogenesis and Possible Evaluation Technologies

et al. 2019

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Diabetes mellitus (DM) is a rapidly increasing problem in health care worldwide: recent forecast indicates that the number of DM patients will rise to 640 million by 2040. Vascular damage is associated with severe complications, including cardiac neuropathy and limb amputation. Therefore, early prediction of diabetic vascular damage using advanced technologies is an important challenge because timely preventive and therapeutic measures could diminish the risk of development and burden of complications. The aim of the article is to provide a review of the initial stages of vascular damage and main mechanisms for development, as well as appropriate modern technologies for prediction and diagnosis. The manuscript provides an overview of interrelated vascular damage mechanisms influenced by diabetes, along with a review of possible technologies for early prediction and diagnosis. A comparative analysis of technologies appropriate for particular issues of prediction is summarised in the discussion.INDEX TERMS Arterial stiffness and atherosclerosis, diabetes mellitus vascular complications, endothelial dysfunction, evaluation technologies. V. DEVELOPMENT OF INTIMA AND MEDIA CALCIFICATION AND ITS EVALUATION METHODS

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Relationship between increased left atrial volume and microvascular complications in patients with type 2 diabetes

Cited by 12 publications

References 43 publications

Cardiac Computed Tomography Angiographic Findings as Predictors of Late Heart Failure in an Asymptomatic Diabetic Cohort: An 8-Year Prospective Follow-Up Study

Cardiac Computed Tomography Angiographic Findings as Predictors of Late Heart Failure in an Asymptomatic Diabetic Cohort: An 8-Year Prospective Follow-Up Study

Association between Severity of Diabetic Retinopathy and Cardiac Function in Patients with Type 2 Diabetes

Diabetic Vascular Damage: Review of Pathogenesis and Possible Evaluation Technologies

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