Research Of Ultrasonographic Evaluation Of Left Atrial And Carotid Artery Functional Impairment In Early Diabetic Nephropathy

Objective To evaluate the left atrial and carotid artery functional impairment in early stage diabetic nephropathy using two-dimensional speckle tracking imaging(2D-STI)and ultrafast imaging(UFI).Methods Twenty-five patients with simple diabetes(diabetes group),28 patients with early stage diabetic nephropathy(diabetic nephropathy)and 27 healthy volunteers(healthy control group)were selected.The mean peak longitudinal strain rate of left trial in systolic phase(m SRs),mean peak longitudinal strain rate of left trial in end-diastolic phase(m SRe)and mean peak longitudinal strain rate of left trial in early-diastolic phase(m SRa)were detected by 2D-STI.Carotid artery elastic parameters such as beginning of the systole pulse wave velocity(BS-PWV)and end of the systole pulse wave velocity(ES-PWV)were detected by UFI technique.The clinic data,routine echocardiographic parameters,left atrial wall strain rate and carotid artery elastic parameters among 3 groups were compared by one-way ANOVA.The correlation between left atrial wall strain parameters and elastic parameters was analyzed by Spearman correlation analysis.Results Systolic blood pressure,diastolic blood pressure and body mass index were statistically significant in the three groups(all P < 0.05).The absolute value of m SRe and m SRs decreased gradually (-1.97±0.11,-1.76±0.21,-1.19±0.35;2.61±0.30,2.09±0.39,1.74±0.36;P <0.01)from healthy control group,simple diabetic group and diabetic nephropathy,and the differences between any two groups were statistically significant(all P<0.05).The absolute value of m SRa,increasing trend was found from simple diabetes group,to healthy control group,and to diabetic nephropathy(-3.02±0.19,-2.72±0.22,-2.40±0.45,P < 0.01),and the differences between any two groups were statistically significant(all P < 0.05);The value of BS-PWV,increasing trend was found from simple diabetes group,to healthy control group,and to diabetic nephropathy(4.57±0.75,5.32±0.85,6.46±1.12)m/s;The value of ES-PWV,increasing trend was found from simple diabetes group,to healthy control group,and todiabetic nephropathy(6.73±1.07,7.82±0.72,9.87±1.31)m/s,and the differences between any two groups were statistically significant(all P <0.01).Spearman correlation analysis showed that BS-PWV and ES-PWV were negatively correlated with m SRs(r=-0.549 and r=-0.551,all P< 0.01).BS-PWV and ES-PWV were positively correlated with m SRe(r=0.662 and r=0.664,all P < 0.01).ES-PWV were positively correlated with m SRa(r=0.445,P<0.01)BS-PWV were weakly correlated with m SRa(r=0.242,P=0.039).Conclusion The diabetic patients have a tendency to increase the damage of the left atrial and carotid artery function as the renal function is damaged.2D-STI technology can quantitatively evaluate the left atrial function damage in early stage of diabetic nephropathy,UFI technology can quantitatively evaluate carotid artery function damage in early stage of diabetic nephropathy.Left atrial function impairment is related to carotid arterioscleros of patients with simple diabetes and diabetic nephropathy.