Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano IRCCS, Viale della Resistenza 23, 20036, Meda, Italy.
Int J Cardiovasc Imaging. 2020 Jan;36(1):15-22. doi: 10.1007/s10554-019-01680-z. Epub 2019 Jul 31.
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.
我们旨在研究 2 型糖尿病（DM）患者的左心房（LA）时相性功能与功能能力之间的关系。本横断面研究纳入了 72 名对照者和 64 例无并发症的 DM 患者。所有参与者均接受了超声心动图检查和心肺运动试验。DM 患者的总 LA 排空分数（EF）和被动 LA 排空分数（EF），即 LA 储备和输送功能，均显著低于对照组。LA 主动 EF，即 LA 助推泵功能的参数，在 DM 和对照组之间相似。总 LA 应变和正 LA 应变，与储备和输送功能相对应，在 DM 患者中也明显低于对照组。然而，与对照组相比，DM 患者的负 LA 应变-即 LA 助推泵功能的参数，明显增加。与对照组相比，DM 患者的最大摄氧量显著降低，通气/二氧化碳斜率升高。在整个研究人群中，LA 整体纵向应变与 1 分钟内心率恢复、最大摄氧量和通气/二氧化碳斜率独立相关，与其他临床参数以及 LV 肥厚和 LV 舒张功能无关。总之，DM 患者的 LA 时相性功能和功能能力明显受损。在整个研究人群中，LA 纵向应变而不是 LA 容量指数，与功能能力独立相关。我们的研究结果表明，LA 功能和功能能力的评估可以检测无并发症 DM 患者的亚临床靶器官损伤，并预防进一步并发症的发生。
