Left atrial function and left atrial-left ventricular coupling assessed by vector flow mapping and two-dimensional tissue tracking echocardiography in patients with type 2 diabetes mellitus

Abstract

Objective To detect left atrial (LA) function and left ventricular (LV)-LA coupling using vector flow mapping (VFM) and two-dimensional tissue tracking (2DTT) echocardiography in patients with diabetes. Methods A total of 51 patients with type 2 diabetes (DM group) and 38 healthy volunteers (control group) were studied. LA and LV strain were assessed by 2DTT. The energy loss (EL) of LA and LV during ventricular systole (ELs), early diastole (ELed), and atrial contraction (ELac) were measured by VFM. Results LVEL in DM group was significantly increased compared to that in control group (P<0.05). LAELs and LAELed in control group were higher than those in DM group (P<0.05); while LAELac decreased in control group (P<0.05). Multivariate regression analysis identified E and LVELed as independent predictors of LAELed; Peak torsion, LA peak systolic strain and LVELac were independent predictors of LAELac. Conclusions The reservoir and conduit function of LA are impaired in patients with DM, while the pump function increases as a compensation. Abnormal LA-LV coupling also appears in patients with DM. Key words: Echocardiography; Diabetes mellitus, type 2; Atrial function, left; Left atrial-left ventricular coupling; Vector flow mapping; Two-dimensional tissue tracking imaging