Key result
Coexisting type 2 diabetes and hypertension additively impaired left atrial reservoir longitudinal strain compared to either condition alone (β -3.931; 95% CI -6.237 to -1.624; P=0.001).
Why the study?
Type 2 diabetes mellitus and hypertension often coexist and contribute to left atrial functional abnormalities, but their potential interaction effect on LA function was unclear.
Does the coexistence of type 2 diabetes mellitus and hypertension have an additive adverse effect on left atrial function compared to either condition alone or healthy controls?
Observational (n=180)
Does the coexistence of type 2 diabetes mellitus and hypertension have an additive adverse effect on left atrial function compared to either condition alone or healthy controls?
Effect estimate: β -3.931 (95% CI -6.237 to -1.624)
p-value: p=0.001
The coexistence of type 2 diabetes mellitus and hypertension has an additive adverse effect on left atrial function, leading to greater impairment than either condition alone.
Background: Type 2 diabetes mellitus (T2DM) and hypertension (HT) often coexist and contribute to left atrial (LA) functional abnormalities. The aim of the present study was to explore whether there is a potential interaction effect between T2DM and HT on LA function. Methods: A total of 135 patients (45 with T2DM only, 45 with HT only, and 45 with both T2DM and HT) were enrolled and compared to 45 age- and sex-matched controls. LA volume fraction, including LA ejection fraction (LAEF), LA expansion index (LAEI), LA passive emptying fraction (LAPEF), and LA active emptying fraction (LAAEF), and strain parameters, including LA reservoir longitudinal strain (LASr), LA conduit longitudinal strain (LAScd), and LA contraction longitudinal strain (LASct), were obtained using three-dimensional echocardiography (3DE). Results: Patients with T2DM had significantly more impaired LA reservoir and conduit functions compared to those without T2DM (P<0.05), and patients with HT had a significantly more impaired LA reservoir function, conduit function, and booster pump function compared to those without HT (P<0.05). Two-way analysis of variance showed that there were significant additive interaction effects between T2DM and HT with respect to LASr (P T2DM + HT =0.002) and LAScd (P T2DM + HT =0.001). Generalized linear model demonstrated that T2DM + HT had a greater relative contribution than either T2DM or HT alone to the LA strain indexes, even after adjustment for other confounders (LASr, β T2DM + HT =−3.931, 95% CI: −6.237 to −1.624, P=0.001; LAScd, β T2DM + HT =−3.781, 95% CI: −5.653 to −1.908, P<0.001). Conclusions: Both T2DM and HT had an adverse effect on LA function. The coexistence of both conditions further impaired LA performance in an additive interaction fashion.
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Wang et al. (2023) conducted an observational in Type 2 diabetes mellitus and hypertension (n=180). Coexistence of Type 2 diabetes mellitus and hypertension vs. T2DM alone, HT alone, and healthy controls was evaluated on Left atrial reservoir longitudinal strain (LASr) (β -3.931, 95% CI -6.237 to -1.624, p=0.001). Coexisting type 2 diabetes and hypertension additively impaired left atrial reservoir longitudinal strain compared to either condition alone (β -3.931; 95% CI -6.237 to -1.624; P=0.001).
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