Relationship of the total atrial conduction time to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus

• Published in: Clinics (São Paulo, Brazil) Vol. 70; no. 2; pp. 73 - 80
• Main Authors: Bakirci, Eftal Murat, Demirtas, Levent, Degirmenci, Husnu, Topcu, Selim, Demirelli, Selami, Hamur, Hikmet, Buyuklu, Mutlu, Akbas, Emin Murat, Ozcicek, Adalet, Ozcicek, Fatih, Ceyhun, Gokhan, Topal, Ergun
• Format: Journal Article
• Language: English; Portuguese
• Published: United States Elsevier España, S.L.U 01.02.2015; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; Faculdade de Medicina / USP; Elsevier España
• Subjects: Adult; Atherosclerosis - diagnosis; Atherosclerosis - physiopathology; C-Reactive Protein - analysis; Carotid Intima-Media Thickness; Case-Control Studies; Clinical Science; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - physiopathology; Echocardiography, Doppler - methods; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart Conduction System - diagnostic imaging; Heart Conduction System - physiopathology; Humans; Inflammation; Inflammation - blood; Inflammation - physiopathology; Left Atrial Strain; Lymphocytes - cytology; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Neutrophils - cytology; Predictive Value of Tests; Regression Analysis; ROC Curve; Single-Blind Method; Subclinical Atherosclerosis; Total Atrial Conduction Time; Ventricular Function, Left; Total Atrial Conduction Time; Inflammation; Subclinical Atherosclerosis; Left Atrial Strain
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.6061/clinics/2015(02)01

The aim of our study was to evaluate the total atrial conduction time and its relationship to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus. A total of 132 patients with type 2 diabetes mellitus (mean age 54.5±9.6 years; 57.6% male) and 80 age- and gender-matched controls were evaluated. The total atrial conduction time was measured by tissue-Doppler imaging and the carotid intima-media thickness was measured by B-mode ultrasonography. The total atrial conduction time was significantly longer in the patients with type 2 diabetes mellitus than in the control group (131.7±23.6 vs. 113.1±21.3, p<0.001). The patients with type 2 diabetes mellitus had significantly increased carotid intima-media thicknesses, neutrophil to lymphocyte ratios and high-sensitivity C-reactive protein levels than those of the controls. The total atrial conduction time was positively correlated with the high-sensitivity C-reactive protein level, neutrophil to lymphocyte ratio, carotid intima-media thickness and left atrial volume index and negatively correlated with the early diastolic velocity (Em), Em/late diastolic velocity (Am) ratio and global peak left atrial longitudinal strain. A multiple logistic regression analysis demonstrated that the neutrophil to lymphocyte ratio, carotid intima-media thickness and global peak left atrial longitudinal strain were independent predictors of the total atrial conduction time. We suggest that subclinical atherosclerosis and inflammation may represent a mechanism related to prolonged total atrial conduction time and that prolonged total atrial conduction time and impaired left atrial myocardial deformation may be represent early subclinical cardiac involvement in patients with type 2 diabetes mellitus.