Benchea Laura-Cătălina, Anghel Larisa, Zăvoi Alexandra, Chiuariu Traian, Birgoan Silviu-Gabriel, Sascău Radu Andy, Stătescu Cristian
Internal Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700503 Iași, Romania.
Cardiology Department, Cardiovascular Diseases Institute "Prof. Dr. George I. M. Georgescu", 700503 Iași, Romania.
Biomedicines. 2024 Jul 29;12(8):1690. doi: 10.3390/biomedicines12081690.
Speckle tracking echocardiography is an innovative imaging technique that evaluates myocardial motion, including the function of the left atrium (LA). The assessment of the left atrium's function across its dimensions can have diagnostic and prognostic roles in various cardiovascular conditions. Left atrial strain has been recognized as a valuable predictor of mortality and cardiovascular incidents in the general population across various conditions. For individuals with type 2 diabetes mellitus (T2DM), left atrial dysfunction, as gauged by speckle tracking echocardiography, appears particularly prognostic. Parameters such as peak atrial longitudinal strain (PALS) and left atrial stiffness have been linked with heightened risks of severe cardiovascular events, including atrial fibrillation (AF), heart failure (HF) hospitalizations, or mortality. Consequently, recognizing left atrial dysfunction early is crucial for accurate diagnosis, guiding treatment choices, comprehensive patient management, and prognosis evaluation. Using two-dimensional (2D) speckle tracking echocardiography, results from recent studies report that treatment with empagliflozin significantly enhanced LA function in patients with type 2 diabetes mellitus, improving left atrial strain (LAS) contraction and reservoir values. Furthermore, treatments with glucagon-like peptide-1 (GLP)-1 receptor agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors were shown to improve LA reservoir strain more effectively than insulin alone, suggesting their potential in reducing cardiovascular complications in T2DM patients. This narrative review further addresses ongoing challenges and potential enhancements needed to boost the clinical value of left atrium strain, emphasizing its significance in managing and improving outcomes for diabetic patients.
斑点追踪超声心动图是一种创新的成像技术，可评估心肌运动，包括左心房（LA）的功能。评估左心房在各个维度上的功能在各种心血管疾病中具有诊断和预后作用。左心房应变已被认为是各种情况下普通人群死亡率和心血管事件的重要预测指标。对于2型糖尿病（T2DM）患者，通过斑点追踪超声心动图测量的左心房功能障碍似乎具有特别的预后意义。诸如心房纵向应变峰值（PALS）和左心房僵硬度等参数与严重心血管事件（包括心房颤动（AF）、心力衰竭（HF）住院或死亡）的风险增加有关。因此，早期识别左心房功能障碍对于准确诊断、指导治疗选择、全面的患者管理和预后评估至关重要。使用二维（2D）斑点追踪超声心动图，最近的研究结果报告称，恩格列净治疗可显著增强2型糖尿病患者的左心房功能，改善左心房应变（LAS）收缩和储备值。此外，与单独使用胰岛素相比，胰高血糖素样肽-1（GLP）-1受体激动剂和钠-葡萄糖协同转运蛋白-2（SGLT-2）抑制剂治疗能更有效地改善左心房储备应变，表明它们在降低T2DM患者心血管并发症方面的潜力。这篇叙述性综述进一步探讨了提高左心房应变临床价值所需应对的持续挑战和潜在改进措施，强调了其在糖尿病患者管理和改善预后方面的重要性。
