Evaluation of the role of left atrial strain using two-dimensional speckle tracking echocardiography in patients with diabetes mellitus and heart failure with preserved left ventricular ejection fraction

• Published in: Diabetes & vascular disease research Vol. 13; no. 6; pp. 384 - 394
• Main Authors: Georgievska-Ismail, Ljubica, Zafirovska, Planinka, Hristovski, Zarko
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.11.2016
• Subjects: Aged; Atrial Function, Left; Biomechanical Phenomena; Chi-Square Distribution; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetic Cardiomyopathies - diagnostic imaging; Diabetic Cardiomyopathies - etiology; Diabetic Cardiomyopathies - physiopathology; Echocardiography, Doppler - methods; Female; Heart Failure - diagnostic imaging; Heart Failure - etiology; Heart Failure - physiopathology; Humans; Linear Models; Male; Middle Aged; Myocardial Contraction; Predictive Value of Tests; Prospective Studies; Risk Factors; Stress, Mechanical; Stroke Volume; Ventricular Function, Left; heart failure with preserve left ventricular ejection fraction; diabetes mellitus; Left atrial deformation; speckle tracking echocardiography
• ISSN: 1479-1641; 1752-8984
• DOI: 10.1177/1479164116655558

Objective: To evaluate additional role of left atrial two-dimensional speckle tracking echocardiography in patients with diabetes mellitus type 2, 218 patients with heart failure with preserved left ventricular ejection fraction divided according to the presence of diabetes mellitus (108 with and 110 without) were enrolled in the study. Methods: Traditional parameters using two-dimensional echocardiography and Doppler imaging were measured as expressions of left ventricular diastolic function as well as peak atrial longitudinal strain and peak atrial contraction strain were measured using two-dimensional speckle tracking echocardiography. Results: Global average peak atrial longitudinal strain and peak atrial contraction strain were significantly lower in patients with diabetes mellitus (p = 0.002 and p = 0.001, respectively) and its reduced values were significantly associated with higher prevalence of diabetes mellitus (p = 0.002 and p = 0.001, respectively), its greater severity (p = 0.002 and p = 0.016, respectively) and longer duration only for global average peak atrial longitudinal strain (p = 0.030). Multiple linear regression analysis demonstrated that the presence of diabetes mellitus appeared as independent predictor of reduced global peak atrial longitudinal strain [B = −2.173; 95% confidence interval: −3.870 to (−0.477); p = 0.012] as well of reduced global peak atrial contraction strain [B = −1.30; 95% confidence interval: −2.234 to (−0.366); p = 0.007]. Conclusion: Two-dimensional speckle tracking echocardiography appeared as a useful additional tool for detection of left atrial dysfunction in patients with heart failure who have preserved left ventricular ejection fraction and diabetes mellitus who are especially prone to develop cardiovascular complications.