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Changes in left atrial volume in diabetes mellitus: more than diastolic dysfunction?

journal contribution
posted on 2023-05-18, 00:28 authored by Kadappu, KK, Boyd, A, Eshoo, S, Haluska, B, Yeo, AET, Thomas MarwickThomas Marwick, Thomas, L
Aim To evaluate left atrial (LA) volume and function as assessed by strain and strain rate derived from 2D speckle tracking and their association with diastolic dysfunction (DD) in patients with diabetes mellitus (DM).
Methods and results Seventy three patients with DM were compared with age- and gender-matched normal controls; 30 patients with DM alone were compared to those with hypertension (HT) alone. The maximum LA volume, traditional measures of atrial function, 2D strain and strain rate were analysed. The LA indexed volume (LAVI) was larger in DM group than that in normal controls (38.2 ± 9.9 vs. 20.5 ± 4.8 ml/m2, P< 0.0001), as well as in DM alone compared with hypertensive patients (33.9 ± 10 vs. 25.7 ± 8 ml/m2, P< 0.0001). Global strain was significantly reduced in the DM group compared with that in normal controls (22.5 ± 8.67 vs. 30.6 ± 8.27%; P< 0.0001) but was similar with HT. There was a weak correlation between LAVI and global strain with increasing grades of DD (r= 0.439, P< 0.0001 and r= − 0.316, P< 0.0001, respectively) in the diabetic group. However, there was no significant difference in LAVI between these groups. A logistic regression analysis for predictors of LAVI demonstrated that only diabetes was a determinant of LAVI. Patients with diabetes showed a significant reduction in global strain compared with normal controls but no difference with increasing grades of diastolic function.
Conclusions LA enlargement in DM is independent of associated HT and diastolic function. LA enlargement is associated with LA dysfunction as evaluated by 2D strain. It is likely that a combination of DD and a diabetic atrial myopathy contribute to LA enlargement in patients with DM.

History

Publication title

European Heart Journal Cardiovascular Imaging

Volume

13

Issue

12

Pagination

1016-1023

ISSN

2047-2404

Department/School

Menzies Institute for Medical Research

Publisher

Oxford University Press

Place of publication

United Kingdom

Rights statement

Copyright 2012 The Author

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified