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Complex evaluation of left atrial dysfunction in patients with type 1 diabetes mellitus by three-dimensional speckle tracking echocardiography: results from the MAGYAR-Path Study [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(8): 587-593 | DOI: 10.5152/AnatolJCardiol.2015.6225  

Complex evaluation of left atrial dysfunction in patients with type 1 diabetes mellitus by three-dimensional speckle tracking echocardiography: results from the MAGYAR-Path Study

Attila Nemes1, Györgyike Ágnes Piros1, Csaba Lengyel2, Péter Domsik1, Anita Kalapos1, Tamás T. Várkonyi2, Andrea Orosz3, Tamás Forster1
1Department Of Medicine And Cardiology Centre, Medical Faculty, Albert Szent-györgyi Clinical Center, University Of Szeged, Szeged- Hungary
2Department Of Medicine, Medical Faculty, Albert Szent-györgyi Clinical Center, University Of Szeged, Szeged- Hungary
3Department Of Pharmacology And Pharmacotherapy, Medical Faculty, Albert Szent-györgyi Clinical Center, University Of Szeged, Szeged- Hungary

Objective: Changes in left atrial (LA) function can be observed in type 1 diabetes mellitus (T1DM). Three-dimensional (3-D) speckle tracking echocardiography (STE) seems to be a promising tool for volumetric and functional evaluation of LA. The objective of the present study was to compare 3DSTE-derived LA volumetric and strain parameters between T1DM patients and matched healthy controls.
Methods: This prospective study consists of 17 subcutaneous insulin pump-treated non-obese patients with T1DM (mean age: 33.5±8.2 years, 8 males). To exclude possible cardiovascular disease, patients with complaints of chest pain, dyspnea, or signs of cerebrovascular disease or peripheral artery disease were not included. Their results were compared with 20 age-matched and gender-matched healthy controls (mean age: 36.9±11.0 years, 9 males). Independent sample Student t-test and Fisher’s exact test were used for comparisons. Bland–Altman method was used for evaluating intraobserver and interobserver correlations.
Results: Anemia and impaired renal function were not confirmed in T1DM patients. Calculated LA maximum and minimum volumes and LA volume before atrial contraction were significantly increased in T1DM patients. Total atrial stroke volume was increased (23.6±6.9 mL vs. 19.6±4.6 mL, p=0.04), whereas mean segmental circumferential peak strain was decreased (28.9%±11.4% vs. 37.3%±12.5%, p=0.04). Segmental basal longitudinal and area strains were increased, whereas segmental superior circumferential and area strains and midatrial 3-D strain were decreased in T1DM.
Conclusion: Both 3DSTE-derived volumetric and strain analysis confirmed alterations in LA function, suggesting early LA remodeling in patients with T1DM. (Anatol J Cardiol 2016; 16: 000-00)

Keywords: echocardiography, function, left atrium, three-dimensional, diabetes mellitus, speckle-tracking


Attila Nemes, Györgyike Ágnes Piros, Csaba Lengyel, Péter Domsik, Anita Kalapos, Tamás T. Várkonyi, Andrea Orosz, Tamás Forster. Complex evaluation of left atrial dysfunction in patients with type 1 diabetes mellitus by three-dimensional speckle tracking echocardiography: results from the MAGYAR-Path Study. Anatol J Cardiol. 2016; 16(8): 587-593

Corresponding Author: Attila Nemes, Hungary


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