{"title":"2型糖尿病患者与对照组心外膜脂肪厚度与左心房纵深贮液应变的关系","authors":"Maryam Nabati, Farideh Moradgholi, Mahmood Moosazadeh, Homa Parsaee","doi":"10.1186/s13089-023-00338-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) has been documented among the strongest risk factors for developing heart failure with preserved ejection fraction (HFpEF). The earliest imaging changes in patients with DM are the left atrial (LA) functional and volumetric changes. The aim of this study was to determine the correlation between epicardial fat thickness (EFT) and longitudinal LA reservoir strain (LARS) in patients with type 2 DM (T2DM), as compared with non-diabetic controls.</p><p><strong>Results: </strong>The study samples in this case-control study comprised of consecutive patients with T2DM (n=64) and matched non-diabetic controls (n=30). An echocardiography was performed on all patients and EFT, volumetric and longitudinal LARS, left ventricular (LV) global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e') and peak systolic (s') velocities were obtained. The study results demonstrated that the patients with T2DM had thicker EFT (5.96±2.13 vs. 4.10±3.11 mm) and increased LA volume index (LAVI) (43.05± 44.40 vs. 29.10±11.34 ml/m<sup>2</sup>) in comparison with the non-diabetic ones (p-value: 0.005 and 0.022, respectively). On the other hand, a direct association was observed between EFT and the E/e' ratio, and an inverse correlation was established between EFT and LARS in patients with T2DM (r=0.299, p-value=0.020 and r=- 0.256, p-value=0.043, respectively). However, regression analysis showed only LV mass index (LVMI) (β=0.012, 95% CI 0.006-0.019, p-value<0.001), LAVI (β=- 0.034, 95% CI - 0.05-0.017, p-value<0.001), and EFT (β=- 0.143, 95% CI - 0.264-- 0.021, p-value=0.021) were independently correlated with LARS.</p><p><strong>Conclusions: </strong>LARS is considered as an important early marker of subclinical cardiac dysfunction. Thickened epicardial fat may be an independent risk factor for decreased LA reservoir strain. Diabetics are especially considered as a high risk group due to having an increased epicardial adipose tissue thickness.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497481/pdf/","citationCount":"0","resultStr":"{\"title\":\"The correlation between epicardial fat thickness and longitudinal left atrial reservoir strain in patients with type 2 diabetes mellitus and controls.\",\"authors\":\"Maryam Nabati, Farideh Moradgholi, Mahmood Moosazadeh, Homa Parsaee\",\"doi\":\"10.1186/s13089-023-00338-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diabetes mellitus (DM) has been documented among the strongest risk factors for developing heart failure with preserved ejection fraction (HFpEF). The earliest imaging changes in patients with DM are the left atrial (LA) functional and volumetric changes. The aim of this study was to determine the correlation between epicardial fat thickness (EFT) and longitudinal LA reservoir strain (LARS) in patients with type 2 DM (T2DM), as compared with non-diabetic controls.</p><p><strong>Results: </strong>The study samples in this case-control study comprised of consecutive patients with T2DM (n=64) and matched non-diabetic controls (n=30). An echocardiography was performed on all patients and EFT, volumetric and longitudinal LARS, left ventricular (LV) global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e') and peak systolic (s') velocities were obtained. The study results demonstrated that the patients with T2DM had thicker EFT (5.96±2.13 vs. 4.10±3.11 mm) and increased LA volume index (LAVI) (43.05± 44.40 vs. 29.10±11.34 ml/m<sup>2</sup>) in comparison with the non-diabetic ones (p-value: 0.005 and 0.022, respectively). On the other hand, a direct association was observed between EFT and the E/e' ratio, and an inverse correlation was established between EFT and LARS in patients with T2DM (r=0.299, p-value=0.020 and r=- 0.256, p-value=0.043, respectively). However, regression analysis showed only LV mass index (LVMI) (β=0.012, 95% CI 0.006-0.019, p-value<0.001), LAVI (β=- 0.034, 95% CI - 0.05-0.017, p-value<0.001), and EFT (β=- 0.143, 95% CI - 0.264-- 0.021, p-value=0.021) were independently correlated with LARS.</p><p><strong>Conclusions: </strong>LARS is considered as an important early marker of subclinical cardiac dysfunction. Thickened epicardial fat may be an independent risk factor for decreased LA reservoir strain. 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引用次数: 0
摘要
背景:糖尿病(DM)已被证明是发生保留射血分数(HFpEF)心力衰竭的最强危险因素之一。DM患者最早的影像学改变是左心房(LA)功能和容积变化。本研究的目的是确定2型糖尿病(T2DM)患者心外膜脂肪厚度(EFT)和纵向LA储层应变(LARS)之间的相关性，并与非糖尿病对照组进行比较。结果:本病例对照研究的研究样本包括连续的T2DM患者(n=64)和匹配的非糖尿病对照组(n=30)。所有患者均行超声心动图，并获得EFT、容积和纵向LARS、左室(LV)整体纵向应变(LVGLS)、脉冲波多普勒衍生的透射早期(E波)和晚期(A波)舒张速度，以及组织多普勒衍生的二尖瓣环舒张早期(E′)和收缩峰值(s′)速度。研究结果显示，T2DM患者EFT较非糖尿病患者厚(5.96±2.13 vs 4.10±3.11 mm)， LA容积指数(LAVI)较非糖尿病患者增高(43.05±44.40 vs 29.10±11.34 ml/m2) (p值分别为0.005和0.022)。另一方面，T2DM患者EFT与E/ E′比值呈正相关，与LARS呈负相关(r=0.299, p值=0.020,r=- 0.256, p值=0.043)。然而，回归分析仅显示左室质量指数(LVMI) (β=0.012, 95% CI 0.006-0.019, p值)。结论:LARS被认为是亚临床心功能障碍的重要早期标志。心外膜脂肪增厚可能是LA储层应变降低的独立危险因素。由于心外膜脂肪组织厚度增加，糖尿病患者尤其被认为是一个高风险群体。
The correlation between epicardial fat thickness and longitudinal left atrial reservoir strain in patients with type 2 diabetes mellitus and controls.
Background: Diabetes mellitus (DM) has been documented among the strongest risk factors for developing heart failure with preserved ejection fraction (HFpEF). The earliest imaging changes in patients with DM are the left atrial (LA) functional and volumetric changes. The aim of this study was to determine the correlation between epicardial fat thickness (EFT) and longitudinal LA reservoir strain (LARS) in patients with type 2 DM (T2DM), as compared with non-diabetic controls.
Results: The study samples in this case-control study comprised of consecutive patients with T2DM (n=64) and matched non-diabetic controls (n=30). An echocardiography was performed on all patients and EFT, volumetric and longitudinal LARS, left ventricular (LV) global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e') and peak systolic (s') velocities were obtained. The study results demonstrated that the patients with T2DM had thicker EFT (5.96±2.13 vs. 4.10±3.11 mm) and increased LA volume index (LAVI) (43.05± 44.40 vs. 29.10±11.34 ml/m2) in comparison with the non-diabetic ones (p-value: 0.005 and 0.022, respectively). On the other hand, a direct association was observed between EFT and the E/e' ratio, and an inverse correlation was established between EFT and LARS in patients with T2DM (r=0.299, p-value=0.020 and r=- 0.256, p-value=0.043, respectively). However, regression analysis showed only LV mass index (LVMI) (β=0.012, 95% CI 0.006-0.019, p-value<0.001), LAVI (β=- 0.034, 95% CI - 0.05-0.017, p-value<0.001), and EFT (β=- 0.143, 95% CI - 0.264-- 0.021, p-value=0.021) were independently correlated with LARS.
Conclusions: LARS is considered as an important early marker of subclinical cardiac dysfunction. Thickened epicardial fat may be an independent risk factor for decreased LA reservoir strain. Diabetics are especially considered as a high risk group due to having an increased epicardial adipose tissue thickness.
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