Evaluation of the left atrial function by two-dimensional speckle-tracking echocardiography in diabetic patients with obesity
- 13 Downloads
Obesity and diabetes are risk factors for atrial cardiomyopathy and are, thus, deemed public health concerns. However, the effects of obesity on the left atrial (LA) function in patients with diabetes have not been determined yet. We sought to evaluate the effects of obesity on the LA function in patients with type 2 diabetes. Ninety-six consecutive patients with type 2 diabetes without significant coronary artery stenosis in selective coronary angiography were included in this cross-sectional study. Two-dimensional speckle-tracking echocardiography (2DSTE)-derived longitudinal LA myocardial deformation markers were compared between 42 obese and 54 nonobese patients. The longitudinal strain and the longitudinal strain rate of the LA myocardium during the reservoir phase and the contraction phase were reduced in the obese patients with diabetes compared with the nonobese patients with diabetes in the unadjusted analysis. In the adjusted analysis, longitudinal strain and the longitudinal strain rate during the contraction phase and the longitudinal strain rate during the reservoir phase were decreased in the obese patients with diabetes. The reservoir and contraction functions of the LA as evaluated by 2DSTE were decreased in our obese patients with diabetes compared with our nonobese patients with diabetes.
KeywordsLeft atrium Obesity Diabetes Two-dimensional speckle-tracking echocardiography
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all the patients participating in the study.
All the procedures performed in this study involving human patients were in accordance with the ethical standards of our university and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
- 2.Hales CM, Carroll MD, Fryar CD, Ogden CL (2017) Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief 288:1–8Google Scholar
- 12.Abi Khalil C, Sulaiman K, Singh R, Jayyousi A, Asaad N, AlHabib KF, Alsheikh-Ali A, Al-Jarallah M, Bulbanat B, AlMahmeed W, Dargham S, Ridha M, Bazargani N, Amin H, Al-Motarreb A, AlFaleh H, Elasfar A, Panduranga P, Al Suwaidi J (2017) BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure: findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry. Int J Cardiol 241:262–269PubMedCrossRefPubMedCentralGoogle Scholar
- 13.Won KB, Hur SH, Cho YK, Yoon HJ, Nam CW, Kim KB, Bae JH, Choi DJ, Ahn YK, Park JS, Kim HS, Choi RK, Choi D, Kim JH, Han KR, Park HS, Choi SY, Yoon JH, Kwon HC, Rha SU, Hwang KK, Lim DS, Jung KT, Oh SK, Lee JH, Shin ES, Kim KS (2015) Comparison of 2-year mortality according to obesity in stabilized patients with type 2 diabetes mellitus after acute myocardial infarction: results from the DIAMOND prospective cohort registry. Cardiovasc Diabetol 14:141PubMedPubMedCentralCrossRefGoogle Scholar
- 14.Patel H, Bhutani S, Posimreddy S, Shah P, Rampal U, Gandhi A, Vasudev R, Pullatt R, Virk H, Shamoon F, Bikkina M, Goldfarb I (2018) The obesity paradox: the protective effect of obesity on right ventricular function using echocardiographic strain imaging in patients with pulmonary hypertension. Minerva Cardioangiol 66:523–527PubMedCrossRefPubMedCentralGoogle Scholar
- 16.Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T, D'Hooge J, Donal E, Fraser AG, Marwick T, Mertens L, Popescu BA, Sengupta PP, Lancellotti P, Thomas JD, Voigt JU, Industry representatives; Reviewers: This document was reviewed by members of the 2016–2018 EACVI Scientific Documents Committee (2018) Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 19:591–600PubMedCrossRefPubMedCentralGoogle Scholar
- 17.Tadic M, Ilic S, Cuspidi C, Ivanovic B, Bukarica L, Kostic N, Marjanovic T, Kocijancic V, Celic V (2015) Left and right atrial phasic function and deformation in untreated patients with prediabetes and type 2 diabetes mellitus. Int J Cardiovasc Imaging 31:65–76PubMedCrossRefPubMedCentralGoogle Scholar
- 19.Gulel O, Yuksel S, Soylu K, Kaplan O, Yilmaz O, Kahraman H, Sahin M (2009) Evaluation of left atrial functions by color tissue Doppler imaging in adults with body mass indexes %3e or = 30 kg/m(2) versus those %3c30 kg/m (2). Int J Cardiovasc Imaging 25:371–377PubMedCrossRefPubMedCentralGoogle Scholar
- 20.Miyoshi H, Oishi Y, Mizuguchi Y, Iuchi A, Nagase N, Ara N, Oki T (2014) Contribution of obesity to left atrial and left ventricular dysfunction in asymptomatic patients with hypertension: a two-dimensional speckle-tracking echocardiographic study. J Am Soc Hypertens 8:54–63PubMedCrossRefGoogle Scholar
- 22.Goette A, Kalman JM, Aguinaga L, Akar J, Cabrera JA, Chen SA, Chugh SS, Corradi D, D'Avila A, Dobrev D, Fenelon G, Gonzalez M, Hatem SN, Helm R, Hindricks G, Ho SY, Hoit B, Jalife J, Kim YH, Lip GY, Ma CS, Marcus GM, Murray K, Nogami A, Sanders P, Uribe W, Van Wagoner DR, Nattel S (2017) EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. Heart Rhythm 14:e3–e40PubMedCrossRefGoogle Scholar
- 23.Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J, CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612PubMedPubMedCentralCrossRefGoogle Scholar
- 27.Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1–39.e14PubMedCrossRefGoogle Scholar
- 29.Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, Waggoner AD (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 29:277–314PubMedCrossRefGoogle Scholar
- 38.Liao JN, Chao TF, Kuo JY, Sung KT, Tsai JP, Lo CI, Lai YH, Su CH, Hung CL, Yeh HI, Chen SA (2017) Age, sex, and blood pressure-related influences on reference values of left atrial deformation and mechanics from a large-scale Asian population. Circ Cardiovasc Imaging 10:e006077PubMedCrossRefPubMedCentralGoogle Scholar
- 39.Sugimoto T, Robinet S, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Go YY, Marchetta S, Nchimi A, Rosca M, Calin A, Moonen M, Cimino S, Magne J, Cosyns B, Galli E, Donal E, Habib G, Esposito R, Galderisi M, Badano LP, Lang RM, Lancellotti P, NORRE Study (2018) Echocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 19:630–638PubMedCrossRefPubMedCentralGoogle Scholar
- 41.Konerman MC, Greenberg JC, Kolias TJ, Corbett JR, Shah RV, Murthy VL, Hummel SL (2018) Reduced myocardial flow reserve is associated with diastolic dysfunction and decreased left atrial strain in patients with normal ejection fraction and epicardial perfusion. J Card Fail 24:90–100PubMedCrossRefGoogle Scholar