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. 2023 Jul 11:16:2077-2087.
doi: 10.2147/DMSO.S417675. eCollection 2023.

Increased Left Atrial Stiffness is Significantly Associated with Paroxysmal Atrial Fibrillation in Diabetic Patients

Diana-Aurora Arnautu  1   2 , Sergiu-Florin Arnautu  1   3 , Mirela-Cleopatra Tomescu  1   3 , Silvia Luca  2   4 , Constantin-Tudor Luca  2   4
Affiliations

Increased Left Atrial Stiffness is Significantly Associated with Paroxysmal Atrial Fibrillation in Diabetic Patients

Diana-Aurora Arnautu et al. Diabetes Metab Syndr Obes. .

Abstract

Purpose: Atrial fibrillation (AF) and diabetes mellitus (DM) are common pathogenic diseases. Diabetes is an independent risk factor for AF, and coexisting AF is a risk factor for the diabetic pa-tient's progression. The purpose of this study was to see if two-dimensional-speckle tracking echocardiography (2D-STE) might provide valuable criteria for determining the risk of AF in diabetic patients.

Patients and methods: This retrospective study compared 30 adult diabetic patients with documented paroxysmal atrial fibrillation (PAF) with 30 age- and sex-matched diabetic patients without PAF. Inclusion criteria were: age ≥18 years, sinus rhythm, diabetes mellitus type 2, and the ability to sign the informed consent. Exclusion criteria included: moderate or severe valvular disease, previous myocardial infarction, left ventricular ejection fraction (LVEF) <50%, congenital heart disease, a history of cardiac surgery, paced atrial or ventricular rhythm, inadequate echocardiography imaging. The medical history, clinical, biochemical data and the results of the transthoracic cardiac ultrasound examination were registered during their evaluation at the outpatients cardiology clinics.

Results: The mean age of the patients was 62.5±1.7 years, 60% were men. Diabetic patients who experienced PAF episodes demonstrated significantly impaired left atrial (LA) deformation patterns, with decreased LA strains and increased LA stiffness (p < 0.05).

Conclusion: The present study demonstrates that LA strains and LA stiffness are significantly associated with the occurrence of PAF in diabetic patients. As 2D-STE of the LA is more sensitive than routine echocardiographic examination, it should be performed in patients suspected of being suffering from PAF.

Keywords: 2D-speckle tracking echography; diabetes mellitus; left atrial stiffness; left atrial strains; paroxysmal atrial fibrillation.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Two-dimensional speckle tracking ultrasound of the left atrium.
Figure 2
Figure 2
Comparison of left atrial echocardiographic measurements in diabetic patients with and without paroxysmal atrial fibrillation.
Figure 3
Figure 3
Comparison of the ROC curves of LA strain parameters associated with PAF in diabetic patients.
Figure 4
Figure 4
ROC curve analysis for LAsf as independent predictor of PAF in diabetic patients.
See this image and copyright information in PMC

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