ABSTRACT
To investigate left atrium (LA) strain properties of patients with lone atrial fibrillation (LAF) and to assess relationships between LA strain parameters and total atrial conduction time measured with tissue Doppler imaging (PA-TDI). The study population consisted of 53 patients with LAF. The control group was comprised of 50 normal volunteers. Conventional echocardiography indices were measured. Mitral annular velocities and PA-TDI were assessed with TDI. Two-dimensional speckle-tracking echocardiography (2D-STE) was used to assess LA segmental strain and strain rate. Compared with the control group, PA-TDI was significantly prolonged and LA myocardial Ss, SRs, Sa, and SRa were significantly decreased in the LAF group (all P < 0.001). In the control group, LA myocardial Ss (γ = -0.486, P < 0.01), SRs (γ = -0.436, P < 0.01), and Sa (γ = -0.360, P < 0.05) were correlated negatively with PA-TDI. LA myocardial SRa (γ = 0.377, P < 0.01) was correlated positively with PA-TDI. In the LAF group, LA myocardial Ss (γ = -0.429, P < 0.01), SRs (γ = -0.468, P < 0.01), and Sa (γ = -0.380, P < 0.05) were also correlated negatively, and SRa (γ = 0.390, P < 0.01) was correlated positively, with PA-TDI. Multivariate logistic regression identified PA-TDI as the only predictor of AF onset (OR 1.39; 95 % CI 1.02-1.54; P < 0.01). LA strain parameters were decreased and PA-TDI was prolonged in patients with LAF. Structural remodeling of the LA, assessed by 2D-STE, was correlated with electrical remodeling, determined by PA-TDI. Prolonged PA-TDI was independently associated with AF onset.
Subject(s)
Atrial Fibrillation/physiopathology , Atrial Function, Left , Atrial Remodeling , Heart Rate , Action Potentials , Adult , Atrial Fibrillation/diagnostic imaging , Case-Control Studies , Chi-Square Distribution , Echocardiography, Doppler, Color , Echocardiography, Doppler, Pulsed , Female , Humans , Logistic Models , Male , Middle Aged , Mitral Valve/diagnostic imaging , Mitral Valve/physiopathology , Multivariate Analysis , Observer Variation , Odds Ratio , Predictive Value of Tests , Reproducibility of Results , Stress, Mechanical , Time FactorsABSTRACT
AIM: The aim of the study was to detect the echocardiographic sensitive indexes for prediction of the subclinical cardiac dysfunction and to evaluate the relation between Hemoglobin A1c (HbA1c) and myocardial acoustic densitometry as well as cardiac function. METHODS: Fifty DM2 patients (48.5+/-8.6 years) without evident heart disease and 50 age- and sex-matched normal controls (47.6+/-8.8 years) were enrolled. Conventional echocardiography, tissue Doppler imaging and acoustic densitometry of both groups were measured. HbA1c of DM2 patients were determined. RESULTS: There were no significant differences in systolic indexes between the two groups. Mean LV myocardial early diastolic velocity Em and Em/Am were lower in DM group than control group. Mean LV myocardial late diastolic velocity Am and E/Em were higher in DM group than control group. IVS-IBS% and LVPW-IBS% were higher in DM group than control group. IVS-CVIB and LVPW-CVIB were lower in DM group than control group. HbA1c was negatively correlated with E/A (gamma=-0.310, P<0.05), Em (gamma=-0.409, P<0.01), Em/Am (gamma=-0.380, P<0.01) and positively correlated with E/Em (gamma=0.488, P<0.01). Significant positive correlation was present between HbA1c and IVS-IBS% (gamma=0.679, P<0.01), LVPW-IBS% (gamma=0.666, P<0.01). CONCLUSIONS: The diastolic dysfunction and abnormal myocardial acoustic densitometry exist before the systolic function damage in DM2 patients. Tissue Doppler imaging and ultrasonic integrated backscatter can be used as sensitive means for early assessing myocardial histological changes in DM2 patients. HbA1c is related with both diastolic dysfunction and acoustic densitometry.
