title: Relationship between increased left atrial volume and microvascular complications in patients with type 2 diabetes.
abstract: OBJECTIVE
  We assessed whether left atrial volume index (LAVI) was associated with the presence of microvascular complications in patients with type 2 diabetes, and whether this association was independent of hemodynamic and non-hemodynamic factors.
  
  
  METHODS
  We studied 157 consecutive outpatients with type 2 diabetes with no previous history of ischemic heart disease, chronic heart failure and valvular diseases. A transthoracic echocardiography and myocardial perfusion scintigraphy were performed in all participants. Presence of microvascular complications was also recorded.
  
  
  RESULTS
  Overall, 51 patients had decreased estimated glomerular filtration rate and/or abnormal albuminuria, 24 had diabetic retinopathy, 22 had lower-extremity sensory neuropathy, and 67 (42.7%) patients had one or more of these microvascular complications (i.e., combined endpoint). After stratifying patients by LAVI, those with LAVI ≥32 ml/m(2) had a greater prevalence of microvascular complication, lower left ventricular (LV) ejection fraction, higher LV mass index and higher E/e' ratio than those with LAVI <32 ml/m(2). Logistic regression analyses revealed that microvascular complications (singly or in combination) were associated with increased LAVI, independently of age, sex, diabetes duration, hemoglobin A1c, hypertension, LV-ejection fraction, LV mass index and the E/e' ratio.
  
  
  CONCLUSIONS
  These results indicate that microvascular diabetic complications are associated with increased LAVI in well-controlled type 2 diabetic patients with preserved systolic function and free from ischemic heart disease, independently of multiple potential confounders.
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonapace
authors.affiliation: Section of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Lipari
authors.affiliation: Division of General Medicine and Diabetes Unit "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bertolini
authors.affiliation: Division of General Medicine and Diabetes Unit "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Zenari
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Lanzoni
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Canali
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Molon
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mantovani
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zoppini
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Bonora
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Barbieri
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
mesh_terms: D000368:Aged; D002306:Cardiac Volume / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000209:etiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging
keywords: Left atrial volume; Microvascular complications; Nephropathy; Neuropathy; Retinopathy; Type 2 diabetes