Left atrial diameter is associated with target organ damage in patients with type 2 diabetes mellitus
- 10 Downloads
This paper aims to investigate whether there is a relationship between left atrial diameter (LAD) and target organ damage (TOD) in patients with type 2 diabetes mellitus (DM). Two-hundred-and-eleven patients with type 2 DM were recruited. Data on left ventricular mass index (LVMI), diabetic retinopathy, carotid intima–media thickness/carotid plaque, micro-albuminuria, and serum creatinine levels were collected to determine whether TOD occurred in patients with type 2 DM. Age, body mass index, waist-hip ratio, a history of DM, Framingham Score, and 10-year risk were used to assess cardiovascular disease risk. Patients were divided into four groups: zero TOD (group I, n = 50), one TOD marker (group II, n = 76), two TOD markers (group III, n = 51), and at least three TOD markers (group IV, n = 34). Using multivariate regression analyses, age, body mass index, waist-hip ratio, a history of DM, Framingham Score, and 10-year risk were significantly associated with LAD. LAD was associated with an increased number of markers for TOD. Univariate analyses demonstrated significant relationships between LAD and TOD in the context of serum creatinine and urinary albumin creatinine ratio (r = 0.292, p < 0.001), creatinine (r = 0.346, p < 0.001), carotid intima–media thickness (r = 0.128, p = 0.032), and LVMI (r = 0.399, p < 0.001). Multivariate regression analyses also determined that LVMI and creatinine were independent predictors of LAD enlargement. LAD may be associated with cardiovascular disease risk. LAD enlargement could be an effective indicator of TOD, particularly renal impairment and left ventricular hypertrophy. Screening for LAD may offer a new and rapid approach for evaluating the severity of DM.
KeywordsDiabetes mellitus Left atrial Cardiomyopathy left ventricular mass Echocardiography
Concept/design: Wei He, Wenhui Zhu, Fengjuan Yao.
Data collection/data analysis/interpretation: Wei He, Wenhui Zhu, Yanqiu Liu, Min Ye.
Drafting article: Wei He, Wenhui Zhu, Wei Li, Hong Lin, Donghong Liu.
Critical revision of article: Haoyu Wang, BSc, Fengjuan Yao.
Running title: Left atrial diameter and target organ damage.
Approval of article: Wei He, Wenhui Zhu,Yanqiu Liu, Min Ye, Haoyu Wang, BSc, Wei Li, Hong Lin, Donghong Liu, Fengjuan Yao.
This work was supported by a grant from the Guangdong Province Science Foundation (No. 20140212; Guangzhou, China).
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 9.Gomez-Marcos MA, et al. Central blood pressure and pulse wave velocity: relationship to target organ damage and cardiovascular morbidity-mortality in diabetic patients or metabolic syndrome. An observational prospective study. LOD-DIABETES study protocol. BMC Public Health. 2010;10:143.CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16(3):233–70.CrossRefPubMedGoogle Scholar
- 19.Truong QA, Banerji D, Ptaszek LM, Taylor C, Fontes JD, Kriegel M, et al. Utility of nonspecific resting electrocardiographic features for detection of coronary artery stenosis by computed tomography in acute chest pain patients: from the ROMICAT trial. Int J Cardiovasc Imaging. 2012;28(2):365–74.CrossRefPubMedGoogle Scholar
- 21.Guzder RN, Gatling W, Mullee MA, Mehta RL, Byrne CD. Prognostic value of the Framingham cardiovascular risk equation and the UKPDS risk engine for coronary heart disease in newly diagnosed type 2 diabetes: results from a United Kingdom study. Diabet Med. 2005;22(5):554–62.CrossRefPubMedGoogle Scholar
- 24.Nagueh SF, Smiseth OA, Appleton CP, Byrd BF III, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314.CrossRefPubMedGoogle Scholar