Association Between Diabetes Mellitus and Left Atrial Strain in Individuals With Hypertension

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-06-17 DOI:10.1111/echo.70226

Camila Mota Guida, Jonathan Batista Souza, Fernando Yue Cesena, Antônio Gabriele Laurinavicius, Márcio Gonçalves Sousa, Andrea de Andrade Vilela, Fernanda Marciano Consolim-Colombo, Jorge Eduardo Assef

{"title":"Association Between Diabetes Mellitus and Left Atrial Strain in Individuals With Hypertension","authors":"Camila Mota Guida, Jonathan Batista Souza, Fernando Yue Cesena, Antônio Gabriele Laurinavicius, Márcio Gonçalves Sousa, Andrea de Andrade Vilela, Fernanda Marciano Consolim-Colombo, Jorge Eduardo Assef","doi":"10.1111/echo.70226","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Atrial remodeling is frequent in patients with diabetes and hypertension, linked to cardiovascular events and elevated left ventricular (LV) filling pressures. Speckle-tracking echocardiography detects these changes early, but data on left atrial (LA) strain in this specific population remain limited and controversial.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Individuals with primary hypertension were divided into two groups: with diabetes DM(+) and without diabetes DM(−). All subjects underwent transthoracic echocardiography. Clinical and echocardiographic characteristics, including LA reservoir (S-LAr), LA conduit (S-LAc), and LA contractile (S-LAct) strains, were compared between the groups. The association between diabetes and LA strain was evaluated in models adjusted for sex, age, body mass index (BMI), ambulatory systolic blood pressure, and LV mass index (LVMI). A possible role of diastolic dysfunction and LV strain on the association between DM and LA strain was evaluated by mediation analyses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 64 patients were included: 29 (45.3%) had both diabetes and hypertension, while 35 (54.7%) had isolated hypertension. Standard echocardiographic parameters did not differ significantly between the DM(+) and DM(−) groups. S-LAr and S-LAc were lower in DM(+) compared to DM(−) (S-LAr: 27.8% ± 7.0% vs. 32.1% ± 6.4%, respectively, <i>p</i> = 0.013; S-LAc: 12.0% ± 4.8% vs. 16.0% ± 5.1%, respectively, <i>p</i> = 0.002). S-LAct was not significantly different between DM(+) and DM(−). After adjusting for multiple variables, diabetes remained significantly associated with lower S-LAr and S-LAc. In mediation analyses, the effect of DM on S-LAr and S-LAc was almost entirely attributed to a direct effect and not mediated by diastolic dysfunction or LV strain.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Diabetes was associated with reduced S-LAr and S-LAc in individuals with hypertension. Speckle-tracking echocardiography may be a more sensitive tool for detecting early atrial dysfunction in this population.</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 6","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-06-17","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.70226","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

Purpose

Atrial remodeling is frequent in patients with diabetes and hypertension, linked to cardiovascular events and elevated left ventricular (LV) filling pressures. Speckle-tracking echocardiography detects these changes early, but data on left atrial (LA) strain in this specific population remain limited and controversial.

Methods

Individuals with primary hypertension were divided into two groups: with diabetes DM(+) and without diabetes DM(−). All subjects underwent transthoracic echocardiography. Clinical and echocardiographic characteristics, including LA reservoir (S-LAr), LA conduit (S-LAc), and LA contractile (S-LAct) strains, were compared between the groups. The association between diabetes and LA strain was evaluated in models adjusted for sex, age, body mass index (BMI), ambulatory systolic blood pressure, and LV mass index (LVMI). A possible role of diastolic dysfunction and LV strain on the association between DM and LA strain was evaluated by mediation analyses.

Results

A total of 64 patients were included: 29 (45.3%) had both diabetes and hypertension, while 35 (54.7%) had isolated hypertension. Standard echocardiographic parameters did not differ significantly between the DM(+) and DM(−) groups. S-LAr and S-LAc were lower in DM(+) compared to DM(−) (S-LAr: 27.8% ± 7.0% vs. 32.1% ± 6.4%, respectively, p = 0.013; S-LAc: 12.0% ± 4.8% vs. 16.0% ± 5.1%, respectively, p = 0.002). S-LAct was not significantly different between DM(+) and DM(−). After adjusting for multiple variables, diabetes remained significantly associated with lower S-LAr and S-LAc. In mediation analyses, the effect of DM on S-LAr and S-LAc was almost entirely attributed to a direct effect and not mediated by diastolic dysfunction or LV strain.

Conclusion

Diabetes was associated with reduced S-LAr and S-LAc in individuals with hypertension. Speckle-tracking echocardiography may be a more sensitive tool for detecting early atrial dysfunction in this population.

查看原文本刊更多论文

高血压患者左心房劳损与糖尿病的关系

心房重构在糖尿病和高血压患者中很常见，与心血管事件和左心室充盈压升高有关。斑点跟踪超声心动图早期检测到这些变化，但在这一特定人群中左心房（LA）菌株的数据仍然有限且有争议。方法将原发性高血压患者分为合并糖尿病（+）组和非糖尿病（-）组。所有受试者均行经胸超声心动图检查。比较两组患者的临床和超声心动图特征，包括LA储层（S-LAr）、LA导管（S-LAc）和LA收缩（S-LAct）菌株。在调整了性别、年龄、身体质量指数（BMI）、动态收缩压和左室质量指数（LVMI）的模型中，评估糖尿病与LA菌株之间的关系。通过中介分析评估舒张功能障碍和左室应变在DM和LA应变相关性中的可能作用。结果共纳入64例患者，其中糖尿病合并高血压29例（45.3%），单纯高血压35例（54.7%）。标准超声心动图参数在DM（+）组和DM（−）组之间无显著差异。DM（+）组S-LAr和S-LAc较DM（-）组低(S-LAr分别为27.8%±7.0%比32.1%±6.4%,p = 0.013；S-LAc: 12.0%±4.8%和16.0%±5.1%,p = 0.002)。S-LAct在DM（+）和DM（−）之间无显著差异。在对多个变量进行调整后，糖尿病仍与较低的S-LAr和S-LAc显著相关。在中介分析中，DM对S-LAr和S-LAc的影响几乎完全归因于直接影响，而不是舒张功能障碍或左室菌株介导的。结论糖尿病与高血压患者S-LAr和S-LAc降低有关。斑点跟踪超声心动图可能是一个更敏感的工具，检测早期心房功能障碍在这一人群。

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.