The right atrium in young patients with type 1 diabetes mellitus: Insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

Introduction: Early onset of cardiomyopathy represented by myocardial volumetric and deformation properties is a major concern for patients with type 1 diabetes mellitus (T1DM). Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel methodology with capability of 3D assessment of the right atrium (RA) via virtual models. The present study was designed for detailed comparative analysis of T1DM-associated RA volumetric and functional abnormalities to those of matched healthy controls to be examined by 3DSTE. Methods: The present study comprised of 17 patients with typical features of T1DM (mean age: 36.4 ± 13.0 years, 59% males). Their results were compared to those of 31 age- and gender-matched healthy controls (mean age: 35.0 ± 2.9 years, 61% males). Results: 3DSTE-derived RA volumes respecting the cardiac cycle and RA stroke volumes and emptying fractions did not show differences between young T1DM patients and matched controls. From peak RA strains representing RA reservoir function, mean segmental RA 3D strain proved to be significantly increased. Some regional basal/midatrial end-systolic peak RA strains were found to be significantly increased as well in T1DM patients as compared to controls. T1DM duration and HbA1c correlated with certain RA strains and RA volume-based functional properties. Conclusions: In young patients with T1DM, preserved RA volumes respecting the cardiac cycle are accompanied with increase in certain regional end-systolic peak RA strains, which seems to be associated with T1DM duration and HbA1c.