title: Left atrial phasic function and heart rate variability in asymptomatic diabetic patients.
abstract: OBJECTIVE
  We evaluated left atrial (LA) phasic function and heart rate variability (HRV) in asymptomatic diabetic patients, and the relationship between HRV indices and LA phasic function assessed by volumes and speckle tracking imaging.
  
  
  METHODS
  This cross-sectional study included 55 asymptomatic patients with type 2 diabetes and 50 healthy controls without cardiovascular risk factors. All study subjects underwent laboratory analyses, complete two-dimensional echocardiography examination (2DE) and 24-h Holter monitoring.
  
  
  RESULTS
  Maximum, minimum LA and pre-A LA volumes and volume indexes are significantly higher in diabetic patients. Total and passive LA emptying fractions (EF), representing the LA reservoir and conduit function, are significantly lower in diabetic subjects. Active LA EF, the parameter of the LA booster pump function, is compensatory increased in diabetic patients. Similar results were obtained by 2DE strain analysis. Cardiac autonomic function, assessed by HRV, is significantly deteriorated in diabetic patients. Time and frequency-domain HRV measures are significantly lower in diabetic subjects than in controls. HbA1c, LV mass index and HRV are associated with total LA EF and longitudinal LA strain independently of age, body mass index and LV diastolic function in the whole study population.
  
  
  CONCLUSIONS
  LA phasic function and cardiac autonomic nervous system assessed by HRV are impacted by diabetes. HbA1c and HRV are independently associated with LA reservoir function evaluated by volumetric and strain methods in the whole study population. This study emphasizes the importance of determination of LA function and HRV as important markers of preclinical cardiac damage and autonomic function impairment in diabetic patients.
authors.affiliation: Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia. marijana_tadic@hotmail.com.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.affiliation: Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
authors.forename: Vladan
authors.initials: V
authors.lastname: Vukomanovic
authors.affiliation: Clinical Research Unit, Istituto Auxologico Italiano, University of Milan-Bicocca, Viale della Resistenza 23, 20036, Meda, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.affiliation: Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Suzic-Lazic
authors.affiliation: Institute for Medical Statistics and Informatics, Doktora Subotica 15, 11000, Belgrade, Serbia.
authors.forename: Dejana
authors.initials: D
authors.lastname: Stanisavljevic
authors.affiliation: Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.|Faculty of Medicine, Doktora Subotica 6, 11000, Belgrade, Serbia.
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D016279:Atrial Function, Left / Q000502:physiology*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: Diabetes; Heart rate variability; Left atrium; Phasic function; Strain