Key result
In patients with type 2 diabetes mellitus, the degree of aortic regurgitation was an independent determinant of left atrial reservoir strain (β = -0.43) and active strain (β = -0.478).
Why the study?
The comprehensive effects of T2DM and chronic aortic regurgitation on cardiac strain remain unexplored.
Does the presence and severity of aortic regurgitation worsen left atrial and ventricular dysfunction in patients with type 2 diabetes mellitus?
Observational (n=391)
No
Does the presence and severity of aortic regurgitation worsen left atrial and ventricular dysfunction in patients with type 2 diabetes mellitus?
Effect estimate: β = -0.43 (95% CI -8.961 to -2.873)
p-value: p=<0.001
Aortic regurgitation exacerbates left atrial and ventricular dysfunction in patients with type 2 diabetes, with the degree of regurgitation independently correlating with impaired left atrial strain.
AR severity links to impaired LA strain in T2DM; leaves open whether AR accelerates dysfunction progression.
Background: The prevalence of type 2 diabetes mellitus (T2DM) and chronic aortic regurgitation (AR) increases with age and might increase cardiac morbidity and mortality; however, their comprehensive effects based on cardiac strain remain unexplored. This study aimed to use cardiac magnetic resonance feature tracking to investigate the additive effects of T2DM and AR on the left heart and left-atrioventricular (LA) interaction in patients with T2DM and AR. Methods: A total of 286 patients with T2DM (203 without AR, 83 with AR) and 105 normal controls were retrospectively included from January 2015 to October 2022. The patients with T2DM and AR were divided according to echocardiographic findings into three AR groups: mild (n = 39), moderate (n = 25), and severe (n = 19)]. The LA phasic function and left-ventricular (LV) function parameters were compared to determine the additive effects of T2DM and AR and their interaction. Multivariate analysis was performed to identify the independent indicators of LA longitudinal strain. Results: Compared with controls, the patients with T2DM without AR had a lower total LA emptying fraction (LAEF) and passive LAEF (all P < 0.05). The patients with T2DM and mild AR showed decreased LA reservoir strain (ε s ) and passive strain (ε e ) ( P < 0.001), whereas those with moderate and severe AR showed significant increases in LA volume and LV volume but a decrease in LAEF, LA strain, and LV ejection fraction (all P < 0.05). In the patients with T2DM and AR, the ε s was independently correlated with LV end-diastolic volume (LVEDV) (β = −0.304), regurgitation degree (β = −0.43), and LV mass index (LVMI) (β = −0.312). The active strain (ε a ) was independently correlated with regurgitation degree (β = −0.478) and LVMI (β = −0.364), whereas the ε e was independently correlated with age (β = −0.226) and diabetes duration (β = −0.256, all P < 0.05). Conclusion: AR may aggravate LA and LV dysfunction in patients with T2DM. Regurgitation degree was an independent factor contributing to ε s and ε a . Both LVEDV and LVMI were independent determinants affecting ε s , and LVMI was an independent determinant of ε a in patients with T2DM and AR.
No takes yet. Share an insight, caveat, or question.
Shen et al. (2023) conducted an observational in Type 2 diabetes mellitus with or without chronic aortic regurgitation (n=391). Chronic aortic regurgitation vs. Type 2 diabetes without aortic regurgitation and normal controls was evaluated on Left atrial reservoir strain (εs) correlation with regurgitation degree (β = -0.43, 95% CI -8.961 to -2.873, p=<0.001). In patients with type 2 diabetes mellitus, the degree of aortic regurgitation was an independent determinant of left atrial reservoir strain (β = -0.43) and active strain (β = -0.478).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: