Atrioventricular coupling and left atrial abnormality in type 2 diabetes mellitus with functional mitral regurgitation patients verified by cardiac magnetic resonance imaging

Abstract

Background Functional mitral regurgitation (FMR) in type 2 diabetes mellitus (T2DM) patients induced by left ventricular (LV) enlargement and mitral valve abnormality may aggravated the impairment in left atrial (LA) compliance. Thus, this study aimed to depict how FMR and LV dysfunction affect LA compliance in T2DM patients with FMR. Materials and methods A total of 148 patients with T2DM and 49 age- and sex-matched normal controls underwent cardiac magnetic resonance examination. LA longitudinal strain and LA and LV functional indices were compared among controls and different T2DM patients. The multivariate analysis was used to identify the independent indicators of LA longitudinal strain. Results T2DM Patients without FMR had a lower total LA empty fraction (LAEF) compared with the controls (all P < 0.05). T2DM patients with mild and moderate FMR showed increased LA volume (LAV) and LV volume while decreased LAEF, LA strain, and LV ejection fraction (P < 0.05). T2DM patients with severe FMR showed markedly increased LAV and LV volume while decreased LAEF, LA strain, and LVEF (P < 0.05). In T2DM patients with FMR, reservoir strain (εs) was independently correlated with LV end-diastolic volume (LVEDV) (β = − 0.334) and regurgitation degree (β = − 0.256). The passive strain (εe) was independently correlated with regurgitation degree (β = − 0.297), whereas the active strain (εa) was independently correlated with LVESV (β = − 0.352) and glycated haemoglobin (β = − 0.279). Conclusion FMR may aggravate LA and LV dysfunction in T2DM patients. Regurgitation degree was an independent determinant of the εs and the εe, LVEDV was an independent determinant of the εs, and LVESV was an independent determinant of the εa in T2DM patients with FMR.

Left-atrioventricular interaction and left-atrial deformation in type 2 diabetes mellitus patients with or without chronic aortic regurgitation: A 3.0T cardiac magnetic resonance feature-tracking study

“…We speculated that they had a synergistic effect on the mechanism, leading to heart damage and rapid failure of the compensatory mechanism in the left heart [27]. Our study ndings are consistent with those in a report by Zhang et al stating that LA myocardial impairment in patients with T2DM with mitral regurgitation progressed without compensation [14,28]. Therefore, the occurrence and progression of AR should be considered in managing patients with T2DM.…”

Effect of Metabolic Dysfunction‐Associated Fatty Liver Disease on Left Ventricular Deformation and Atrioventricular Coupling in Patients With Metabolic Syndrome Assessed by MRI

“…The maximum LA volume (LAV max ), minimum LA volume (LAV min ), and preatrial contraction LA volume (LAV pre ) were calculated by using the biplane modified Simpson method. The tissue tracking module automatically generated the LA peak longitudinal reservoir strain (LA‐RS), conduit strain (LA‐CS), and booster strain (LA‐BS) 16 (Fig. 1).…”

Adverse association of epicardial adipose tissue accumulation with cardiac function and atrioventricular coupling in postmenopausal women assessed by cardiac magnetic resonance imaging

“…Left atrial parameters were obtained as previously described (13). LA structural parameters included maximum LA volume (LAV max ), minimum LA volume (LAV min ), and pre-atrial contraction LA volume (LAV ac ).…”