title: Relationship of the total atrial conduction time to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  The aim of our study was to evaluate the total atrial conduction time and its relationship to subclinical atherosclerosis, inflammation and echocardiographic parameters in patients with type 2 diabetes mellitus.
  
  
  METHODS
  A total of 132 patients with type 2 diabetes mellitus (mean age 54.5 ± 9.6 years; 57.6% male) and 80 age- and gender-matched controls were evaluated. The total atrial conduction time was measured by tissue-Doppler imaging and the carotid intima-media thickness was measured by B-mode ultrasonography.
  
  
  RESULTS
  The total atrial conduction time was significantly longer in the patients with type 2 diabetes mellitus than in the control group (131.7 ± 23.6 vs. 113.1 ± 21.3, p<0.001). The patients with type 2 diabetes mellitus had significantly increased carotid intima-media thicknesses, neutrophil to lymphocyte ratios and high-sensitivity C-reactive protein levels than those of the controls. The total atrial conduction time was positively correlated with the high-sensitivity C-reactive protein level, neutrophil to lymphocyte ratio, carotid intima-media thickness and left atrial volume index and negatively correlated with the early diastolic velocity (Em), Em/late diastolic velocity (Am) ratio and global peak left atrial longitudinal strain. A multiple logistic regression analysis demonstrated that the neutrophil to lymphocyte ratio, carotid intima-media thickness and global peak left atrial longitudinal strain were independent predictors of the total atrial conduction time.
  
  
  CONCLUSIONS
  We suggest that subclinical atherosclerosis and inflammation may represent a mechanism related to prolonged total atrial conduction time and that prolonged total atrial conduction time and impaired left atrial myocardial deformation may be represent early subclinical cardiac involvement in patients with type 2 diabetes mellitus.
authors: Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Eftal Murat
authors: EM
authors: Bakirci
authors: Department of Internal Medicine, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Levent
authors: L
authors: Demirtas
authors: Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Husnu
authors: H
authors: Degirmenci
authors: Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors: Selim
authors: S
authors: Topcu
authors: Department of Cardiology, Erzurum Education and Research Hospital, Erzurum, Turkey.
authors: Selami
authors: S
authors: Demirelli
authors: Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Hikmet
authors: H
authors: Hamur
authors: Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Mutlu
authors: M
authors: Buyuklu
authors: Department of Internal Medicine, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Emin Murat
authors: EM
authors: Akbas
authors: Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors: Adalet
authors: A
authors: Ozcicek
authors: Department of Internal Medicine, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Fatih
authors: F
authors: Ozcicek
authors: Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Gokhan
authors: G
authors: Ceyhun
authors: Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors: Ergun
authors: E
authors: Topal
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D016037:Single-Blind Method; D016277:Ventricular Function, Left
chemical_list: D002097:C-Reactive Protein