Key result
Hypertension reduced early diastolic left atrial longitudinal strain compared to controls (14.9% vs 22.1%, P<0.001), with further impairment seen in patients with coexisting diabetes (12.3%, P<0.05).
Why the study?
Does coexisting diabetes further impair left atrial phasic function assessed by 2DSTE in patients with hypertension?
Observational (n=190)
Does coexisting diabetes further impair left atrial phasic function assessed by 2DSTE in patients with hypertension?
Absolute Event Rate: 14.9% vs 22.1%
p-value: p=<0.001
2D speckle tracking echocardiography demonstrates that hypertension impairs left atrial reservoir and conduit functions, which are further worsened by coexisting diabetes.
Suggests additive LA impairment by diabetes in hypertension; leaves open whether 2DSTE strain informs management.
OBJECTIVE: To evaluate the left atrial phasic function of hypertensive patients with or without coexisting diabetes using two-dimensional speckle tracking echocardiography (2DSTE)-based strain and strain rate imaging and volumetric parameters. METHODS: The study included an isolated hypertension group (HT group) comprising 99 patients, a hypertension and diabetes group (HT + DM group) comprising 65 patients, and 26 age-matched healthy controls. The 2DSTE-based strain and strain rate images were studied, and the following parameters were measured: peak left atrial longitudinal strain (LAS-S ), early diastolic (LAS-E ) and late diastolic (LAS-A ) atrial longitudinal strains, and systolic (LASR-S ), early diastolic (LASR-E ) and late diastolic (LASR-A ) strain rates. RESULTS: The LAS-S and LASR-S were lower in the HT group and the HT + DM group compared with the control group (P < 0.001). The LAS-E and LASR-E were lower in the HT group (14.9 ± 5.5% and -1.1 ± 0.4/sec, respectively) than in the control group (22.1 ± 8.3% and -1.7 ± 0.6/sec, respectively) (P < 0.001), and they were further depressed in the HT + DM group (12.3 ± 6.3% and -1.0 ± 0.4/sec, respectively) (P < 0.05). There were no significant differences in LAS-A or LASR-A among the 3 groups (P > 0.05). Multivariate regression analysis revealed that HT and DM were independently related to LAS-E and LASR-E . CONCLUSIONS: Hypertension can lead to abnormal left atrial reservoir and conduit functions, and coexisting diabetes can further impair conduit function. 2DSTE-derived strain and strain rate imaging are sensitive methods for evaluating left atrial phasic function.
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Liu et al. (2013) conducted an observational in Hypertension and diabetes (n=190). Hypertension with or without diabetes vs. Healthy controls was evaluated on Early diastolic left atrial longitudinal strain (LAS-E) (p=<0.001). Hypertension reduced early diastolic left atrial longitudinal strain compared to controls (14.9% vs 22.1%, P<0.001), with further impairment seen in patients with coexisting diabetes (12.3%, P<0.05).
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