The Value Of Left Atrial Strain In Assessing Left Ventricular Diastolic Function In Patients With T2DM

Objective:Cardiovascular complications are the leading cause of death in patients with type2 diabetes mellitus(T2DM),and abnormal diastolic function is positively associated with mortality in patients with T2 DM,with a high incidence and insidious onset.Prevention of cardiovascular complications in T2 DM patients is the first priority to save the lives of T2 DM patients.In this study,we applied 2D-STI to measure LASr,LAScd,and LASct in the T2 DM and control groups,to understand the changes of left ventricular diastolic function in T2 DM patients,in order to detect cardiovascular complications in T2 DM patients at an extremely early stage,and to provide clinical support for the prevention of cardiovascular complications in T2 DM patients.It is also hoped that we can contribute to the reduction of mortality caused by cardiovascular complications in patients with T2 DM.Methods:A total of 100 patients with T2 DM who were hospitalized in the Department of Endocrinology and Metabolism of Feng xian District Central Hospital affiliated to Anhui University of Technology from January 2020 to September 2021 were collected.According to normal diastolic function,patients with T2 DM were divided into normal left ventricular diastolic function group(group A,n= 50),abnormal left ventricular diastolic function group(group B,n = 50)and control group(group C,n = 50)without diabetes,heart disease and normal cardiac function in the same period.Off-line analysis and data processing were performed on the two-dimensional images of routine echocardiography in each group.LASr,LAScd,LASct,left atrial volume and left atrial volume index were measured by two-dimensional speckle tracking technique.Age,SBP,PP,DM duration,FBG,HDL-C,Hb Alc,LAD,LVPWT,IVST,EDT,E/e’,LA Volume,LAVI and LASr,LASct,LAScd were compared in each group.Pearson/Spearman correlation was used to analyze the relationship between LASr,LAScd,LASct and clinical baseline data,biochemical indexes and cardiac ultrasound parameters.Binary Logistic regression was used to analyze the independent risk factors of left ventricular diastolic dysfunction in patients with T2 DM.ROC curve was drawn to analyze the sensitivity and specificity of LASr,LAScd and LASct in the evaluation of left ventricular diastolic dysfunction.The Bland-Altman method was used to analyze the intra-observer and inter-observer consistency of LASr,LAScd and LASct.Results:The levels of LASr,LAsct and LAScd in T2 DM patients with abnormal left ventricular diastolic function were significantly lower than those in normal controls(P< 0.001).The Pearson/Spearman correlation analysis of LASr,LASct,LAScd with clinical baseline data,biochemical indexes and echocardiographic parameters showed that LASr,LASct and LAScd were negatively correlated with Age,DM duration,SBP,PP,BNP,LAD,E/e’,LA Volume and LAVI,(P<0.05).Binary logistic regression analysis showed that LASr was an independent risk factor for impaired left ventricular diastolic function in patients with type 2 diabetes mellitus.The results of ROC curve analysis showed that LASr had high sensitivity and specificity in evaluating left ventricular diastolic function abnormality in patients with T2DM(AUC=0.936,95%CI=0.883-0.990,P<0.001).Bland-Altman analysis showed that the intra-observer and inter-observer consistency and reproducibility of LASr,LASct and LAScd measured by 2D-STI analysis software were high.Conclusion:The evaluation of left ventricular diastolic function in T2 DM patients by 2D-STI has high sensitivity and specificity.LASr has certain value in early prediction of left ventricular diastolic dysfunction in T2 DM patients.Figure [11] table [9] reference [106]...