Predictive Value of Left Atrial Structure and Function Parameters in Left Ventricular Remodeling in Patients With Type 2 Diabetes Mellitus

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-05-14 DOI:10.1111/echo.70196

Yumeng Xing, Rui Zhao, Xiaoli Zhang, Jiamei Jin, Yiming Yang, Haier Wang, Yan Wang, Chunyan Zhong, Lin Chen, Yinjia Zhang

{"title":"Predictive Value of Left Atrial Structure and Function Parameters in Left Ventricular Remodeling in Patients With Type 2 Diabetes Mellitus","authors":"Yumeng Xing, Rui Zhao, Xiaoli Zhang, Jiamei Jin, Yiming Yang, Haier Wang, Yan Wang, Chunyan Zhong, Lin Chen, Yinjia Zhang","doi":"10.1111/echo.70196","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The 4-dimensional automated left atrial quantification (4D Auto LAQ) technology for the left atrium was recently available. We aimed to evaluate LA function using 4D Auto LAQ in patients with type 2 diabetes mellitus (T2DM) and investigate its value in predicting left ventricular remodeling (LVR).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 106 T2DM patients (56 with left ventricular [LV] remodeling and 50 with normal geometry) and 46 age- and sex-matched controls were enrolled. LA total emptying fraction (LATEF), LA active emptying fraction (LAAEF), LA passive emptying fraction (LAPEF), and strain parameters, including LA reservoir longitudinal/circumferential strain (LASr/LASr-c), LA conduit longitudinal/circumferential strain (LAScd/LAScd-c), and LA contraction longitudinal/circumferential strain (LASct/LASct-c), were assessed with 4D Auto LAQ.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Compared to controls, LASr, LAScd, and LAPEF significantly decreased in both groups of T2DM patients (<i>p</i> < 0.001). T2DM patients with LVR had significantly lower LASr and LAScd than those with normal geometry (<i>p</i> < 0.001). LATEF was also reduced in T2DM patients with LVR compared to the control group (<i>p</i> < 0.05). Among the 4D-LAQ parameters, only LASr (odds ratio [OR]: 0.860, <i>p</i> = 0.016) was associated with LV remodeling (LVR) in multivariate analysis. Receiver operating characteristic (ROC) curves identified a LASr value of ≤22.5% as the optimal cutoff point to predict LVR in the T2DM cohort (sensitivity, 86.0%; specificity, 64.3%; area under the curve [AUC], 0.770; <i>p</i> < 0.001). In addition, LASr was found to be negatively correlated with both LV mass index (LVMI) and relative wall thickness (RWT) but positively correlated with the absolute value of the LV global longitudinal strain (LVGLS).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Impairment of LA reservoir and conduit functions can be observed in patients with T2DM, particularly in those with LVR. LASr may serve as a predictor of LVR in patients with T2DM.</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/echo.70196","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The 4-dimensional automated left atrial quantification (4D Auto LAQ) technology for the left atrium was recently available. We aimed to evaluate LA function using 4D Auto LAQ in patients with type 2 diabetes mellitus (T2DM) and investigate its value in predicting left ventricular remodeling (LVR).

Methods

A total of 106 T2DM patients (56 with left ventricular [LV] remodeling and 50 with normal geometry) and 46 age- and sex-matched controls were enrolled. LA total emptying fraction (LATEF), LA active emptying fraction (LAAEF), LA passive emptying fraction (LAPEF), and strain parameters, including LA reservoir longitudinal/circumferential strain (LASr/LASr-c), LA conduit longitudinal/circumferential strain (LAScd/LAScd-c), and LA contraction longitudinal/circumferential strain (LASct/LASct-c), were assessed with 4D Auto LAQ.

Results

Compared to controls, LASr, LAScd, and LAPEF significantly decreased in both groups of T2DM patients (p < 0.001). T2DM patients with LVR had significantly lower LASr and LAScd than those with normal geometry (p < 0.001). LATEF was also reduced in T2DM patients with LVR compared to the control group (p < 0.05). Among the 4D-LAQ parameters, only LASr (odds ratio [OR]: 0.860, p = 0.016) was associated with LV remodeling (LVR) in multivariate analysis. Receiver operating characteristic (ROC) curves identified a LASr value of ≤22.5% as the optimal cutoff point to predict LVR in the T2DM cohort (sensitivity, 86.0%; specificity, 64.3%; area under the curve [AUC], 0.770; p < 0.001). In addition, LASr was found to be negatively correlated with both LV mass index (LVMI) and relative wall thickness (RWT) but positively correlated with the absolute value of the LV global longitudinal strain (LVGLS).

Conclusions

Impairment of LA reservoir and conduit functions can be observed in patients with T2DM, particularly in those with LVR. LASr may serve as a predictor of LVR in patients with T2DM.

查看原文本刊更多论文

左房结构和功能参数对2型糖尿病患者左室重构的预测价值

背景近年来出现了用于左心房的四维自动左心房定量（4D Auto LAQ）技术。我们的目的是利用4D Auto LAQ评价2型糖尿病（T2DM）患者的左心室功能，并探讨其在预测左心室重构（LVR）中的价值。方法选取T2DM患者106例（左室重构56例，左室几何形状正常50例）和年龄、性别匹配的对照组46例。采用4D Auto LAQ评价LA总排空率（LATEF）、LA主动排空率（LAAEF）、LA被动排空率（LAPEF）以及LA储层纵向/周向应变（LASr/LASr-c）、LA导管纵向/周向应变（LAScd/LAScd-c）、LA收缩纵向/周向应变（LASct/LASct-c）等应变参数。结果与对照组相比，两组T2DM患者的LASr、LAScd和LAPEF均显著降低(p <；0.001)。T2DM合并LVR患者的LASr和LAScd明显低于正常几何形状患者(p <；0.001)。T2DM合并LVR患者的LATEF也比对照组降低(p <；0.05)。多因素分析显示，在4D-LAQ参数中，只有LASr（比值比[OR]: 0.860, p = 0.016）与左室重构（LVR）相关。受试者工作特征（ROC）曲线确定LASr值≤22.5%为预测T2DM队列LVR的最佳截断点(敏感性86.0%；特异性,64.3%;曲线下面积[AUC]， 0.770；p & lt;0.001)。此外，LASr与左室质量指数（LVMI）和相对壁厚（RWT）均呈负相关，而与左室总纵向应变（LVGLS）绝对值呈正相关。结论2型糖尿病患者，尤其是LVR患者，可观察到LA储层和导管功能的损害。LASr可作为T2DM患者LVR的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.