title: Complex evaluation of left atrial dysfunction in patients with type 1 diabetes mellitus by three-dimensional speckle tracking echocardiography: results from the MAGYAR-Path Study.
abstract: OBJECTIVE
  Changes in left atrial (LA) function can be observed in type 1 diabetes mellitus (T1DM). Three-dimensional (3-D) speckle tracking echocardiography (STE) seems to be a promising tool for volumetric and functional evaluation of LA. The objective of the present study was to compare 3DSTE-derived LA volumetric and strain parameters between T1DM patients and matched healthy controls.
  
  
  METHODS
  This prospective study consists of 17 subcutaneous insulin pump-treated non-obese patients with T1DM (mean age: 33.5±8.2 years, 8 males). To exclude possible cardiovascular disease, patients with complaints of chest pain, dyspnea, or signs of cerebrovascular disease or peripheral artery disease were not included. Their results were compared with 20 age-matched and gender-matched healthy controls (mean age: 36.9±11.0 years, 9 males). Independent sample Student t-test and Fisher's exact test were used for comparisons. Bland-Altman method was used for evaluating intraobserver and interobserver correlations.
  
  
  RESULTS
  Anemia and impaired renal function were not confirmed in T1DM patients. Calculated LA maximum and minimum volumes and LA volume before atrial contraction were significantly increased in T1DM patients. Total atrial stroke volume was increased (23.6±6.9 mL vs. 19.6±4.6 mL, p=0.04), whereas mean segmental circumferential peak strain was decreased (28.9%±11.4% vs. 37.3%±12.5%, p=0.04). Segmental basal longitudinal and area strains were increased, whereas segmental superior circumferential and area strains and midatrial 3-D strain were decreased in T1DM.
  
  
  CONCLUSIONS
  Both 3DSTE-derived volumetric and strain analysis confirmed alterations in LA function, suggesting early LA remodeling in patients with T1DM.
authors.affiliation: 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary. nemes.attila@med.u-szeged.hu.
authors.forename: Attila
authors.initials: A
authors.lastname: Nemes
authors.affiliation: 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Györgyike Ágnes
authors.initials: GÁ
authors.lastname: Piros
authors.affiliation: 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Lengyel
authors.affiliation: 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Domsik
authors.affiliation: 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Kalapos
authors.affiliation: 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Tamás T
authors.initials: TT
authors.lastname: Várkonyi
authors.affiliation: Department of Pharmacology and Pharmacotherapy, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Orosz
authors.affiliation: 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Forster