Is there association between left atrial function and functional capacity in patients with uncomplicated type 2 diabetes?

We sought to investigate the relationship between phasic left atrial function (LA) and functional capacity in the patients with type 2 diabetes (DM). This cross-sectional investigation included 72 controls and 64 uncomplicated DM subjects. All participants underwent echocardiographic examination and cardiopulmonary exercise testing. Total and passive LA emptying fractions (EF), demonstrating LA reservoir and conduit function, were significantly lower in DM patients than in controls. Active LA EF, the parameter of LA booster pump function, was similar between DM and controls. Total and positive LA strains, corresponding with reservoir and conduit function, were also significantly reduced in DM subjects comparing with controls. However, negative LA strain-parameter of LA booster pump function, was significantly increased in DM patients in comparison with controls. Peak oxygen consumption was significantly reduced and ventilation/carbon dioxide slope was elevated in DM patients. In the whole study population LA global longitudinal strain was associated with heart rate recovery in the first minute, peak oxygen consumption and ventilation/carbon dioxide slope independently of other clinical parameters and LV hypertrophy and LV diastolic function. In conclusion, LA phasic function and functional capacity were significantly impaired in the patients with DM. LA longitudinal strain, but not LA volume index, was independently related with functional capacity in the whole study population. Our results suggest that evaluation of LA function and functional capacity could detect subclinical target organ damage and prevent development of further complications in uncomplicated DM patients.