Gulmez Oyku, Parildar Hulya, Cigerli Ozlem, Demirağ Nilgun
Department of Cardiology, Baskent University, Istanbul Medical and Research Centre, Istanbul, Turkey. Email:
Department of Family Medicine, Baskent University, Istanbul Medical and Research Centre, Istanbul, Turkey.
Cardiovasc J Afr. 2018;29(2):82-87. doi: 10.5830/CVJA-2017-048. Epub 2017 Nov 30.
Changes in left atrial (LA) size and function are associated with adverse clinical events. Recently, duration of diabetes mellitus (DM2) has been found to be positively associated with increased LA volume and impaired LA function. This study was performed, using two-dimensional echocardiograpy, to evaluate the changes in LA volume and function in patients with DM2 with a disease duration of six months, and to assess the parameters that affect LA volume and function.
Fifty-six patients (28 male, age: 52.6 ± 6.5 years) with DM2 and 56 controls (24 male; age: 50.1 ± 7.0 years) were enrolled in the study. Each subject underwent conventional two-dimensional echocardiography to assess LA volume (indexed maximal LA volume: V, pre-atrial contraction volume: V, minimal LA volume: V) and LA function [passive emptying volume - passive emptying fraction (PEV - PEF), active emptying volume - active emptying fraction (AEV - AEF), total emptying volume - total emptying fraction (TEV - TEF) ].
LA diameter, indexed V, V, V, AEV and TEV were found to be significantly higher in the DM2 group compared with the controls (p < 0.05). Indexed V, V and V were significantly correlated with HbA level, body mass index (BMI), high-sensitivity C-reactive protein and uric acid levels, mitral A wave, E/E' ratio and A' wave. According to multivariate analysis, age and BMI had a statistically significant effect on LA volume.
Impaired LA function may be present in patients with newly diagnosed DM2. BMI and increasing age caused LA enlargement and LA volumes that were independent of the effects of hypertension and DM2.
左心房（LA）大小和功能的改变与不良临床事件相关。最近，发现2型糖尿病（DM2）病程与左心房容积增加和左心房功能受损呈正相关。本研究采用二维超声心动图评估病程6个月的DM2患者左心房容积和功能的变化，并评估影响左心房容积和功能的参数。
本研究纳入了56例DM2患者（28例男性，年龄：52.6±6.5岁）和56例对照者（24例男性；年龄：50.1±7.0岁）。每位受试者均接受常规二维超声心动图检查，以评估左心房容积（最大左心房容积指数：V、心房收缩前容积：V、最小左心房容积：V）和左心房功能[被动排空容积-被动排空分数（PEV-PEF）、主动排空容积-主动排空分数（AEV-AEF）、总排空容积-总排空分数（TEV-TEF）]。
发现DM2组的左心房直径、V指数、V、V、AEV和TEV均显著高于对照组（p<0.05）。V指数、V和V与糖化血红蛋白水平、体重指数（BMI）、高敏C反应蛋白和尿酸水平、二尖瓣A波、E/E'比值和A'波显著相关。多因素分析显示，年龄和BMI对左心房容积有统计学显著影响。
新诊断的DM2患者可能存在左心房功能受损。BMI和年龄增长导致左心房扩大及左心房容积增加，这与高血压和DM2的影响无关。
