369 Left Atrial Strain is not Associated With Reduced Exercise Capacity in Diabetes Mellitus Subjects

Abstract

Reduced left atrial (LA) strain has been reported in diabetes mellitus (DM). We sought to assess LA strain in DM and its association with exercise capacity. DM and matched controls prospectively performed exercise echocardiography and VO2peak studies. Peak LA strain and LA contractile strain was measured from the apical 4-chamber view via speckle tracking echocardiography. Student t-tests and Pearson’s correlation assessed for statistical associations. Fifty-eight subjects (38 DM and 20 age/sex-matched controls) were included. Mean age was 43±13 years (69% male). DM subjects were overweight (BMI 27±4 vs 25±3 kg/m2, p=0.009) with lower left atrial volume index (33.9±9.0 vs 39.8±8.5ml/m2, p=0.018), paradoxically higher E/e’ ratio (10±3 vs 8±2, p=0.041), lower LV global longitudinal strain (LVGLS) (-19±2 vs -20±2%, p=0.045) and lower VO2peak (33±9 vs 40±1ml/min/kg, p=0.007). BNP was similar (12±11 vs 11±8pg/ml, p=0.55). There was a non-significant trend to lower peak longitudinal LA strain (28.2±5.5 vs 31.7±8.2%, p=0.059) and LA contractile strain (10.3±4.3 vs 12.3±5.4%, p=0.144) in DM subjects compared to controls. A non-significant negative correlation between peak LA strain and DM was observed (r=-0.25, p=0.059). Peak LA strain did not correlate with BMI (r=-0.176, p=0.185), VO2peak (r=0.079, 0.556), or E/e’ (r=-0.018, p=0.893), and was negatively correlated with LVGLS (r=-0.374, p=0.004). We did not identify significant associations between peak LA strain and VO2peak in DM subjects. Larger studies are required to explore the associations and significance of LA strain in DM.