Marijana Tadic1, Vladan Vukomanovic2, Cesare Cuspidi3, Jelena Suzic-Lazic2, Dejana Stanisavljevic4, Vera Celic2,5. 1. Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia. marijana_tadic@hotmail.com. 2. Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia. 3. Clinical Research Unit, Istituto Auxologico Italiano, University of Milan-Bicocca, Viale della Resistenza 23, 20036, Meda, Italy. 4. Institute for Medical Statistics and Informatics, Doktora Subotica 15, 11000, Belgrade, Serbia. 5. Faculty of Medicine, Doktora Subotica 6, 11000, Belgrade, Serbia.
Abstract
AIMS: We evaluated left atrial (LA) phasic function and heart rate variability (HRV) in asymptomatic diabetic patients, and the relationship between HRV indices and LA phasic function assessed by volumes and speckle tracking imaging. METHOD: This cross-sectional study included 55 asymptomatic patients with type 2 diabetes and 50 healthy controls without cardiovascular risk factors. All study subjects underwent laboratory analyses, complete two-dimensional echocardiography examination (2DE) and 24-h Holter monitoring. RESULTS: Maximum, minimum LA and pre-A LA volumes and volume indexes are significantly higher in diabetic patients. Total and passive LA emptying fractions (EF), representing the LA reservoir and conduit function, are significantly lower in diabetic subjects. Active LA EF, the parameter of the LA booster pump function, is compensatory increased in diabetic patients. Similar results were obtained by 2DE strain analysis. Cardiac autonomic function, assessed by HRV, is significantly deteriorated in diabetic patients. Time and frequency-domain HRV measures are significantly lower in diabetic subjects than in controls. HbA1c, LV mass index and HRV are associated with total LA EF and longitudinal LA strain independently of age, body mass index and LV diastolic function in the whole study population. CONCLUSIONS: LA phasic function and cardiac autonomic nervous system assessed by HRV are impacted by diabetes. HbA1c and HRV are independently associated with LA reservoir function evaluated by volumetric and strain methods in the whole study population. This study emphasizes the importance of determination of LA function and HRV as important markers of preclinical cardiac damage and autonomic function impairment in diabetic patients.
AIMS: We evaluated left atrial (LA) phasic function and heart rate variability (HRV) in asymptomatic diabeticpatients, and the relationship between HRV indices and LA phasic function assessed by volumes and speckle tracking imaging. METHOD: This cross-sectional study included 55 asymptomatic patients with type 2 diabetes and 50 healthy controls without cardiovascular risk factors. All study subjects underwent laboratory analyses, complete two-dimensional echocardiography examination (2DE) and 24-h Holter monitoring. RESULTS: Maximum, minimum LA and pre-A LA volumes and volume indexes are significantly higher in diabeticpatients. Total and passive LA emptying fractions (EF), representing the LA reservoir and conduit function, are significantly lower in diabetic subjects. Active LA EF, the parameter of the LA booster pump function, is compensatory increased in diabeticpatients. Similar results were obtained by 2DE strain analysis. Cardiac autonomic function, assessed by HRV, is significantly deteriorated in diabeticpatients. Time and frequency-domain HRV measures are significantly lower in diabetic subjects than in controls. HbA1c, LV mass index and HRV are associated with total LA EF and longitudinal LA strain independently of age, body mass index and LV diastolic function in the whole study population. CONCLUSIONS: LA phasic function and cardiac autonomic nervous system assessed by HRV are impacted by diabetes. HbA1c and HRV are independently associated with LA reservoir function evaluated by volumetric and strain methods in the whole study population. This study emphasizes the importance of determination of LA function and HRV as important markers of preclinical cardiac damage and autonomic function impairment in diabeticpatients.
Entities:
Keywords:
Diabetes; Heart rate variability; Left atrium; Phasic function; Strain
Authors: Aseel Alfuhied; Gaurav S Gulsin; Lavanya Athithan; Emer M Brady; Kelly Parke; Joseph Henson; Emma Redman; Anna-Marie Marsh; Thomas Yates; Melanie J Davies; Gerry P McCann; Anvesha Singh Journal: Int J Cardiovasc Imaging Date: 2022-03-02 Impact factor: 2.357