title: Evidence of left atrial remodeling and left ventricular diastolic dysfunction in type 2 diabetes mellitus with preserved systolic function.
abstract: Prognosis of type 2 diabetes is associated with the occurrence of cardiovascular diseases. Left atrial (LA) size is a predictor of outcome in several diseases, including diabetes. Long duration of diabetes is an established risk factor of poor prognosis. No data are available on the relationship between LA size and duration of diabetes. The present study was aimed to investigate the relationship between LA volume index (LAVI) and the duration of diabetes to test the hypothesis that LA volume will increase as a function of diabetes duration.
  
  
  
  Forty-four male patients with newly diagnosed and 172 male patients with established type 2 diabetes were recruited for this cross-sectional study. All patients were evaluated with a transthoracic echocardiographic Doppler. About 28.2% of patients had increased LAVI. Indices of both diastolic and systolic function were significantly lower in patients with larger left atrium. The values of LAVI increased across classes of duration of diabetes. In multivariable analysis, longer duration was a predictor of LAVI ≥34 ml/m2(odds ratio 1.65, 95% CI 1.11-2.46, p = 0.014) after adjusting for age, hemoglobin A1c, hypertension, microvascular complication status, and relevant echocardiographic parameters of systolic and diastolic function.
  
  
  
  These results indicate that duration of diabetes is strongly and positively associated with larger LAVI in type 2 diabetic men with preserved systolic function. Future studies are needed to better elucidate the biological mechanisms underlying linking type 2 diabetes with abnormally increased LAVI in subjects with type 2 diabetes.
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy. Electronic address: giacomo.zoppini@univr.it.
authors.forename: G
authors.initials: G
authors.lastname: Zoppini
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: S
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: C
authors.initials: C
authors.lastname: Bergamini
authors.affiliation: Section of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Trombetta
authors.affiliation: Division of Cardiology, "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Lanzoni
authors.affiliation: Division of General Medicine and Diabetes Unit "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bertolini
authors.affiliation: Division of General Medicine and Diabetes Unit "Sacro Cuore" Hospital, Negrar (VR), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Zenari
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonora
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Targher
mesh_terms: D000368:Aged; D064752:Atrial Remodeling; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D058065:Diabetic Cardiomyopathies / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology; D003971:Diastole; D015150:Echocardiography, Doppler; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Diabetes duration; LAVI; Transthoracic echocardiography; Type 2 diabetes