Assessment Of Left Atrial Function In Patients With Type 2 Diabetes Mellitus By Real-time Three-dimensional Echocardiography And Speckle Tracking Imaging

Background and purpose of the study:With the development of economic level,the incidence of diabetes mellitus?DM?increases,and the complications become higher.Sustained elevation of blood glucose will directly or indirectly affect the function of myocardium,cardiac remodeling,hypertrophy,or dilation of the heart chamber,which leads to arrhythmia,heart failure,and other systemic complications of the patient,reducing the quality of life of the patient.Therefore,early detection of symptomatic treatment of cardiac dysfunction in patients with diabetes can not only improve cardiac function but also improve the quality of life in diabetes.Studies have shown that diabetes can cause changes in the volume and function of left atrial?LA?.In the clinical work,the size of left atrium is assessed by measuring the diameter of left atrium with two-dimensional ultrasound.However,the overall change of left atrium will be ignored,and the change of the capacity of the left atrium and the change of the function cannot be reflected.This study aimed to assess left atrial volume in patients with type 2 diabetes?T2DM?accurately and quantitatively by real-time three-dimensional echocardiography?RT-3DE?,measure the function of left atrial by speckle tracking imaging?STI?.It reflects the changes of left atrial myocardial function and provides accurate information for clinical treatment.Methods:In the case group,30 patients with type 2 diabetes were selected.In the control group,30 persons were selected,whose height,weight,and body mass index?BMI?were matched with the case group.Firsly,the left atrial full-volume 3D dynamic images of the apical4-chamber view were acquired transthoracically and stored by GE Vivid E9.Secondly,the images were analysed offline by the EchoPAC software which were carried randomly.The maximum left atrial volume(LAV_max),minimum left atrial volume(LAV_min)and left atrial pre-atrial contraction volume(LAV_olp)were obtained automatically.And then,the index left atrial total emptying volume?LATEVI?,left atrial total emptying fraction?LATEF?,index left atrial passive emptying volume?LAPEVI?,left atrial passive emptying fraction?LAPEF?,index left atrial active emptying volume?LAAEVI?,left atrial active emptying fraction?LAAEF?and left atrial expansion index?EI?were calculated.Finally,the strain curves of left atrial,the left atrial negative strain peak?LANS?and left atrial negative strain peak?LAPS?were measured by the technique of STI.The differences between the case group and control group were compared and analyzed.RESULTS:Compared with the normal group,the LAVI_max,the LAVI_min,the LAVI_olp,the LATEVI,the LAAEVI,the absolute value of LANS,and the LAAEF of diabetic patients were significantly increased;Compared with the normal group,the LATEF,the EI,the LAPEF,the LAPS,and the absolute value of LANS+LAPS of diabetic patients were significantly decreased.Differences were statistically significant?P<0.05?.The index of passive emptying volume of left atrial?LAPEVI?was slightly decreased,and the difference was not statistically significant?P>0.05?.Conclusion:Compared with the normal group,the size of left atrial in patients with type 2 diabetes was larger.Left atrial storage function and channel function decreased,and active systolic function increased;The myocardial strain of left atrial decreased in the left ventricular early diastole and left ventricular systole,increased in the left ventricular late diastole.Studies had shown that the real-time three-dimensional ultrasound combined with speckle tracking technology could assess left atrial function in patients with type 2 diabetes.