Research Paper Volume 13, Issue 1 pp 991—1000

Assessment of real-time three-dimensional echocardiography as a tool for evaluating left atrial volume and function in patients with type 2 diabetes mellitus

Xiuyun Li1, , Yanyan Dong1, , Chao Zheng2, , Pengfei Wang1, , Maosheng Xu1, , Chunpeng Zou1, , Liang Wang1, ,

  • 1 Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’ s Hospital of Wenzhou Medical University, Wenzhou 325027, China
  • 2 Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China

Received: June 14, 2020       Accepted: October 27, 2020       Published: December 3, 2020      

https://doi.org/10.18632/aging.202218
How to Cite

Copyright: © 2020 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: To assess the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating changes in left atrial volume and function in type 2 diabetes mellitus (DM) and type 2 diabetic nephropathy (DN) patients.

Method: 104 control subjects, 109 DN patients, and 111 DM patients were recruited and underwent RT-3DE. Data pertaining to the left atrium were analyzed using the 3DQA software in order to determine left atrial maximum volume index (LAVImax), left atrial pre-systolic volume index (LAVIp), left atrial minimum volume index (LAVImin), total left atrial ejection fraction (LAEFt), passive left atrial ejection fraction (LAEFp), and active left atrial ejection fraction (LAEFa). Differences between these three groups and correlations between individual index values and E/e' ratios were additionally assessed.

Result: LAVImax, LAVIp, and LAVImin were higher in the DN and DM groups relative to controls, whereas LAEFt and LAEFp were higher in controls relative to DM and DN patients (P < 0.05). LAVImax, LAVIp, and LAVImin in the DN group were significantly higher than those in the DM group, while LAEFt, LAEFp were higher in DM patients relative to DN patients (P < 0.05). The E/e' ratio was also found to be significantly correlated with LAVImax, LAVIp, and LAVImin.

Conclusion: Our results indicate that RT-3DE can be used to assess changes in left atrial volume and function in patients with diabetes and can be used to monitor disease progression-related damage to such left atrial functionality.

Abbreviations

DM: diabetes mellitus; DCM: diabetic cardiomyopathy; RT-3DE: real-time three-dimensional echocardiography; DN: diabetic nephropathy; FBG: fasting blood glucose; HbA1c: glycated hemoglobin A1C; SBP: systolic blood pressure; DBP: diastolic blood pressure; BMI: body mass index; HR: heart rate; TG: triglycerides; TC: total cholesterol; HDL-C: high density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; LVEF: left ventricular ejection fraction; LVEDD: left ventricular end-diastolic diameter; LVESD: left ventricular end-systolic diameter; LAD: left atrial diameter; IVST: interventricular septal thickness; LVPWT: left ventricular posterior wall thickness; E: early diastolic peak velocity at the mitral valve orifice; A: late diastolic peak velocity at the mitral valve orifice; e': early diastolic peak velocity of the septal mitral annulus; a': late diastolic peak velocity of the septal mitral annulus; LAVmax: left atrial maximum volume; LAVp: left atrial pre-systolic volume; LAVmin: left atrial minimum volume; LAVmax: left atrial maximum volume; LAVp: left atrial pre-systolic volume; LAVmin: left atrial minimum volume; LAEFt: total left atrial ejection fraction; LAEFp: passive left atrial ejection fraction; LAVImax: left atrial maximum volume index; LAVIp: left atrial pre-systolic volume index; LAVImin: left atrial minimum volume index; LAEFa: active left atrial ejection fraction.