Correlation Between Type II Diabetes Mellitus and Left Atrial Function as Assessed by 2D Speckle-Tracking Echocardiography in Patients Without Coronary Artery Disease

Diabetes mellitus (DM) is associated with several comorbidities and complications such as hypertension, obesity, hyperlipidemia, nephropathy, and cardiovascular diseases. This study aimed to investigate the correlation between the left atrial (LA) function and DM via conventional and speckle-tracking echocardiography (STE).

In this prospective study, from 198 patients with sinus rhythms, 174 patients were included based on inclusion and exclusion criteria. Conventional and STE examinations were done for all the patients. The patients’ demographics, comorbidities, and family history, as well as the results of their angiography or computed tomography angiography, electrocardiography, and echocardiography, were recorded. The variables were compared between the groups with and without DM, and the association between the LA function and DM was studied in the patients.

Totally, 45.2% of the diabetic patients (n = 28) and 38.4% of the nondiabetic patients (n = 30) had diastolic dysfunction (P = 0.384). The diabetic patients had a lower mean of the left ventricular end-diastolic diameter, the LA peak strain during the reservoir phase, the LA pump, and the LA peak positive strain rate during ventricular systole (all Ps < 0.001) and a higher mean of the left ventricular mass index, the A-wave, the E/A, the LA peak negative strain rate during early diastole (all Ps <0.001), the left ventricular end-systolic volume (P = 0.001), the Ea (P = 0.008), the LA ejection fraction (P = 0.011), and the passive emptying volume (P = 0.026).

The results of the present study indicated LA and left ventricular dysfunction in diabetic patients. However, the LA function may be affected by several factors, and our nonrandomized patient selection could also have affected the results. Thus, it is suggested that future randomized clinical trials compare the LA echocardiographic parameters in matched groups