Assessment of left atrial function in diabetes mellitus by left atrial volume tracking method

Abstract

The value of the left atrial volume tracking (LAVT) method in the evaluation of left atrial (LA) function in patients with diabetes mellitus (DM) was examined in this study. Fifty-eight DM patients as DM group and 40 healthy people as normal control group were enrolled in this study. EUB-6500 echocardiographic imaging system with LAVT was applied to display and analyze the LA volume curve imaging on LV apical two and four chamber views. The maximal LA volume at end-systole (LAV(max)), LA volume at the onset of ECG-P wave (LAV(p)), the minimal LA volume at end-diastole (LAV(min)) from the LA volume curve were acquired and recorded. All values above were standardized by body surface area (BSA). Then the passive, active and total LA volume (LAVIpass, LAVIact, LAVItotal) and empting rate (%LAVIpass, %LAVIact, %LAVItotal), effective passive and active empting rate (%eLAVIpass, %eLAVIact), and the proportionality of passive empting volume and active empting volume were calculated. The LAVIp, LAVIact, LAVItotal, %LAVIact, %LAVItotal and %eLAVIact were significantly higher in the DM group than those in the control group, whereas the LAVIpass, %LAVIpass, %eLAVIpass and LAVIpass/act were lower (all P<0.05). For the LA volume change in DM, the active empting volume was enhanced at end-diastole. It was concluded that LAVT is a potentially useful tool to evaluate the function of LA.

Left atrial function: evaluation by strain analysis

“…Earlier studies based on LA phasic volume assessment and tissue Doppler derived strain rate imaging demonstrated impairment in LA reservoir and conduit function in diabetes, occurring in association with increased LV mass, abnormal LV geometry and LV diastolic dysfunction with an associated increase in LA contractile function (58)(59)(60)(61). In a recent study comparing 73 type 2 diabetic patients to age and gender matched normal controls Kadappu et al demonstrated larger indexed LA volumes in diabetics, independent of the effect of hypertension and diastolic dysfunction.…”

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

“…The available data indicate the impairment of left atrial (LA) function in diabetic patients [6][7][8][9][10], whereas information about right atrial (RA) function in this population is still missing. The assessment of atrial function is clinically important because atria are not only reservoirs, but also active contractile chambers that have the ability of ventricular filling during ventricular diastole.…”

Assessment of Left Atrial Functions in Patients with Prediabetes

“…In this study, we demonstrated that indexed LA volumes and AEV, TEV increase significantly in preDM even which is mainly due to BMI and preDM and BMI was the only factor that had significant effect on LA functions. Assessment of LA volumes and functions is a growing interest since changes in LA size and functions are associated with CVE such as atrial fibrillation, stroke, diastolic dysfunction and LV failure in general and diabetic population [9][10][11][12][13][14][15][16][17]. 2D echocardiography derived LA volume provides more accurate assessment of LA size because of the irregular geometry of LA as it often enlarges asymmetrically, resulting in variable shape that may underestimate LA size [6].…”

“…Indexed V max <29 ml/m 2 and indexed LA diameter <24 mm/m 2 for both sexes were defined as normal LA volume and LA diameter for 2D-echocardiographic evaluation [22]. Impairment of LA functions in patients with DM was demonstrated in previous studies by using 2D, 3D echocardiography, myocardial strain imaging, and CMRI.6 [16,17,[23][24][25]. Moreover, Kadappu et al reported that LA dilatation in DM was independent of associated hypertension and diastolic dysfunction which was called atrial cardiomyopathy [8].…”

“…Recently published trial by Kadappu et al demonstrated that LA dilatation and dysfunction may be a coexistent diastolic dysfunction marker in patients with DM [8]. Additionally, most investigators reported LA volumes and functions are independent predictors of CVE in general and diabetic population [9][10][11][12][13][14][15][16][17]. However, there is limited data about the effects of preDM on LA volumes and functions.…”