Mazzone, Carmine;
Cioffi, Giovanni;
Faganello, Giorgio;
Faggiano, Pompilio;
Candido, Riccardo;
Cherubini, Antonella;
Tarantini, Luigi;
De Feo, Stefania;
Di Lenarda, Andrea
Analysis of Left Atrial Performance in Patients with Type 2 Diabetes Mellitus without Overt Cardiac Disease and Inducible Ischemia: High Prevalence of Increased Systolic Force Related to Enhanced Left Ventricular Systolic Longitudinal Function
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Medientyp:
E-Artikel
Titel:
Analysis of Left Atrial Performance in Patients with Type 2 Diabetes Mellitus without Overt Cardiac Disease and Inducible Ischemia: High Prevalence of Increased Systolic Force Related to Enhanced Left Ventricular Systolic Longitudinal Function
Beteiligte:
Mazzone, Carmine;
Cioffi, Giovanni;
Faganello, Giorgio;
Faggiano, Pompilio;
Candido, Riccardo;
Cherubini, Antonella;
Tarantini, Luigi;
De Feo, Stefania;
Di Lenarda, Andrea
Erschienen:
Wiley, 2015
Erschienen in:
Echocardiography, 32 (2015) 2, Seite 221-228
Beschreibung:
<jats:sec><jats:title>Objectives</jats:title><jats:p>In patients with chronic pressure overload, higher left atrial systolic force (<jats:styled-content style="fixed-case">LASF</jats:styled-content>) is associated with high‐risk cardiovascular (<jats:styled-content style="fixed-case">CV</jats:styled-content>) phenotype, with increased left ventricular (<jats:styled-content style="fixed-case">LV</jats:styled-content>) mass, concentric hypertrophy, and diastolic dysfunction. In hypertension and aortic stenosis, <jats:styled-content style="fixed-case">LASF</jats:styled-content> predicts increased rate of <jats:styled-content style="fixed-case">CV</jats:styled-content> events independent of traditional risk factors. Moreover, <jats:styled-content style="fixed-case">LASF</jats:styled-content> is an independent predictor of heart failure in diabetic and nondiabetic patients. Limited data are available about <jats:styled-content style="fixed-case">LASF</jats:styled-content> and its relationship with <jats:styled-content style="fixed-case">LV</jats:styled-content> systolic function in type 2 diabetes mellitus (T2<jats:styled-content style="fixed-case">DM</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We used baseline clinic and echocardiographic data from 333 patients recruited in the <jats:styled-content style="fixed-case">SHORTWAVE</jats:styled-content> study evaluating <jats:styled-content style="fixed-case">LV</jats:styled-content> and left atrial performance in T2<jats:styled-content style="fixed-case">DM</jats:styled-content> patients without cardiac disease. <jats:styled-content style="fixed-case">LASF</jats:styled-content> was calculated by Manning's method and defined high when exceeded 16 Kdynes (90th percentile of <jats:styled-content style="fixed-case">LASF</jats:styled-content> found in 120 healthy subjects used as controls).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Mean <jats:styled-content style="fixed-case">LASF</jats:styled-content> was 15.8 Â ± 9.4 Kdynes/cm<jats:sup>2</jats:sup> and showed a close positive correlation with peak mitral annular systolic velocity (function of <jats:styled-content style="fixed-case">LV</jats:styled-content> longitudinal fibers), independent of E/E′, age, systolic blood pressure, heart rate, and concentric geometry (multiple R = 0.57, P < 0.0001). Such independent correlation (tested in patients with and without concomitant hypertension) was confirmed at multiple logistic regression analysis where patients were dichotomized for having high (119 = 36%) or normal <jats:styled-content style="fixed-case">LASF</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>High <jats:styled-content style="fixed-case">LASF</jats:styled-content> is present in one third of T2<jats:styled-content style="fixed-case">DM</jats:styled-content> patients without overt cardiac disease and is positively and independently related to an increased <jats:styled-content style="fixed-case">LV</jats:styled-content> longitudinal shortening function, suggesting a close interaction between <jats:styled-content style="fixed-case">LV</jats:styled-content> systolic and diastolic function.</jats:p></jats:sec>