title: Early Detection of Left Atrial Energy Loss and Mechanics Abnormalities in Diabetic Patients with Normal Left Atrial Size: A Study Combining Vector Flow Mapping and Tissue Tracking Echocardiography.
abstract: BACKGROUND
  Whether left atrial (LA) functional abnormalities already exist when the LA is of normal size is unknown. The aim of this study was to explore LA energy loss and mechanics changes using vector flow mapping (VFM) and two-dimensional tissue tracking (2DTT) echocardiography in patients with diabetes and normal LA size.
  
  
  METHODS
  This study included 47 normotensive patients with diabetes and 45 controls. The following indexes were measured: LA energy loss during systole (LAELs), early diastole (LAELed), and atrial contraction (LAELac); atrial longitudinal strain during systole (SLAs), early diastole (SLAed) and late diastole (SLAac); and peak LA strain rate during systole (SRLAs), early diastole (SRLAed), and atrial contraction (SRLAac).
  
  
  RESULTS
  The LAELs and LAELed decreased in diabetic patients compared with controls (P=0.002, P<0.01, respectively), whereas the LAELac increased in diabetic patients (P<0.001). The SLAs, SLAed, SRLAs, and SRLAed (all P<0.01) were all lower in diabetic patients than in controls. However, there was no difference in the SLAac and SRLAac between the two groups. Multivariate regression analysis showed that the LAELs, LAELac, and SRLAs were independently associated with HbA(1c) in the whole study population.
  
  
  CONCLUSIONS
  LA energy loss and deformation mechanics are already impaired in diabetic patients with normal LA size and the long-term parameter of glycemic control was correlated with them. VFM combined with 2DTT might be a promising tool for the early detection of LA dysfunction caused by impaired glucose metabolism.
authors.affiliation: Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Medical Image, Shandong Chest Hospital, Jinan, Shandong, China (mainland).
authors.forename: Dailun
authors.initials: D
authors.lastname: Hou
authors.affiliation: Institute of Ultrasound Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland).
authors.forename: Rongchuan
authors.initials: R
authors.lastname: Ma
authors.affiliation: Institute of Ultrasound Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland).
authors.forename: Geqi
authors.initials: G
authors.lastname: Ding
authors.affiliation: Institute of Ultrasound Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland).
authors.forename: Lixue
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
mesh_terms: D001696:Biomechanical Phenomena; D003710:Demography; D003920:Diabetes Mellitus / Q000503:physiopathology*; D042241:Early Diagnosis; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015588:Observer Variation; D009929:Organ Size; D012044:Regression Analysis
chemical_list: D006442:Glycated Hemoglobin