Left atrial structural and functional remodelling study in type 2
diabetic patients in sub-saharan Africa: role of left atrial strain by
2D speckle tracking echocardiography.
Abstract
Objective: To evaluate the role of peak atrial longitudinal strain
(PALS) through speckle tracking 2D echocardiography for the assessment
of structural and functional left atrial (LA) remodelling in a type 2
diabetes mellitus (T2DM) population. Methodology: We conducted a
cross-sectional study during a 9-month period. Were included T2DM adults
aged 18 and above. The variables assessed during the study include age
and gender of participants, diabetes characteristics, cardiovascular
risk factors, clinical anthropometric and haemodynamic parameters,
standard echocardiographic parameters, volume-derived LA functions and
2D PALS. Results: We included a total of 102 patients. The mean age was
58±11.7 years and the M/F sex ratio was 1:1.5. Coexistent arterial
hypertension (HTN) was observed in more than half (59.8%) of the
population sample. Mean 2D PALS was 29.2±8.9% with 58.8% (95%
CI:50.0–68.6) of subjects having a reduced LA strain
(i.e.<32%). Reservoir and pump functions were the most
altered LA volumetric phasic functions. Mean indexed LA maximal volume
was 22.2±6.8 ml/m². There was a significant association between abnormal
PALS and age, Body mass index (BMI), indexed LA volume, E/E’ ratio, LA
active ejection fraction (pump function) and LA expansion index
(reservoir function). Conclusion: LA remodelling is a recurrent
condition in adult T2DM Cameroonians. The Reservoir and pump LA
functions were the most affected. Assessment of LA global strain allows
early detection of LA remodelling with comparison to LA size standard
analyses. Age, BMI, indexed LA volume, E/E’ ratio, reservoir and pump LA
functions were associated to 2D LA global strain impairment.