The association of left atrial volume index and coronary artery disease in type 2 diabetic patients without a history of hypertension and valvular heart disease.

Q: What are the key findings of this study?

Left atrial volume index (LAVI) independently predicted coronary artery disease in normotensive type 2 diabetic patients (OR 1.24, 95% CI 1.06-1.45, P=0.006).

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Type 2 diabetes mellitus undergoing coronary angiography (n=90). Intervention: Left atrial volume index (LAVI) vs. Patients without significant coronary artery stenosis (<50%). Primary outcome: Coronary artery disease (≥50% stenosis on coronary angiography) (OR 1.24, 95% CI 1.06-1.45, p=0.006).

Q: What does this research mean for the field?

Left atrial volume index independently predicts the presence of coronary artery disease in normotensive type 2 diabetic patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mohammad Parsa Mahjoob; Roxana Sadeghi; Mohammad Haji Aghajani; Fatemeh Omidi; Mostafa Rostamnezhad; Mohadese Salehi

doi:10.48305/arya.2026.45203.3051

January 1, 2026Open Access

The association of left atrial volume index and coronary artery disease in type 2 diabetic patients without a history of hypertension and valvular heart disease.

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Key result

Higher LAVI linked to ~24% higher odds of CAD in normotensive diabetic patients.

OR 1.24
95% CI 1.06-1.45
P=0.006
n=90

Figures

Why the study?

Left atrial volume index (LAVI) is a powerful predictor of cardiovascular outcomes, and type 2 diabetes mellitus is a main risk factor for coronary artery disease (CAD). This study examined the association between LAVI and the incidence of CAD in type 2 diabetic patients without hypertension or valvular heart disease.

Is elevated left atrial volume index (LAVI) associated with the presence of angiographic coronary artery disease in type 2 diabetic patients without hypertension or valvular heart disease?

Key Points

To assess the association between echocardiographic left atrial volume index (LAVI) and the presence of coronary artery disease (CAD) in patients with type 2 diabetes without hypertension or valvular heart disease.
Consecutive case-control study of 90 patients with type 2 diabetes aged 18 to 70 years who underwent coronary angiography at Imam Hossein Hospital in Tehran between 2023 and 2024.
Participants were categorized into cases (n = 45 with ≥ 50% coronary stenosis) and controls (n = 45 without significant stenosis); those with hypertension, valvular heart disease, heart failure, or respiratory disease were excluded.
LAVI was measured by echocardiography, and multivariable logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate its predictive performance.
Mean LAVI was significantly higher in patients with CAD (30.73±4.82 mL/m²) compared to those without CAD (28±5.85 mL/m²; P = 0.018).
Multivariate logistic regression identified LAVI as an independent predictor of CAD (OR = 1.24; 95% CI: 1.06–1.45; P = 0.006), whereas age, sex, smoking, and metabolic markers showed no significant association.
ROC curve analysis demonstrated that a LAVI cut-off of 28 mL/m² predicted CAD with an AUC of 0.64, 71.11% sensitivity, and 51.11% specificity (P = 0.016).

Study Design

Type

Case-Control (n=90)

Multicenter

No

Structured PICO

Is elevated left atrial volume index (LAVI) associated with the presence of angiographic coronary artery disease in type 2 diabetic patients without hypertension or valvular heart disease?

P

Population

90 adults with type 2 diabetes mellitus (mean age 51.48 years, 40% female) without hypertension, valvular heart disease, or heart failure undergoing coronary angiography at a single center in Iran.

E

Exposure

Echocardiographic Left Atrial Volume Index (LAVI, mL/m²) evaluation via conventional and speckle-tracking echocardiography (classified as abnormal if ≥34 mL/m²; ROC optimal cut-off >28 mL/m²)

C

Comparator

Control group without significant coronary artery stenosis (<50% narrowing on coronary angiography, n=45) vs. Case group with CAD (≥50% stenosis in at least one coronary artery, n=45)

O

Outcome

Presence of coronary artery disease (defined as ≥50% stenosis in at least one coronary artery on invasive coronary angiography)hard clinical

Main Result

Odds Ratio: 1.24 (95% CI 1.06–1.45)

Absolute Event Rate: 30.73% vs 28%

p-value: p=0.006

Limitations

Certain demographic and clinical variables, such as specific patient medications, were not accounted for.
Omission of other echocardiographic indices and parameters.
Relatively modest predictive accuracy of LAVI at the 28 mL/m² cutoff (AUC 0.64, sensitivity 71.11%, specificity 51.11%).
Single-center, non-random consecutive sampling with a small sample size (n=90).
Patient medications and certain confounding factors were not accounted for
Omission of other echocardiographic indices and parameters
Modest discriminative power of the LAVI cut-off of 28 mL/m² (AUC 0.64, sensitivity 71.11%, specificity 51.11%)
Single-center study with a relatively small sample size (n=90)

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Implication

Echocardiographic LAVI is independently associated with angiographic CAD in normotensive type 2 diabetic patients, though a cutoff of 28 mL/m² offers only modest discriminative accuracy (AUC 0.64).

Abstract

BACKGROUND: Left atrial volume index (LAVI) evaluated using echocardiography serves a powerful predictor of cardiovascular outcomes. Since type 2 diabetes mellitus (T2DM) is a main risk factor for coronary artery disease (CAD), the present investigation was conducted to examine the association between LAVI and incidence of CAD in diabetic patients. METHODS: In this case-control study, 90 type 2 diabetic patients aged 18-70 years who underwent coronary angiography at Imam Hossein Hospital, Tehran, between 2023 and 2024 were consecutively enrolled. Patients with hypertension, valvular heart disease, heart failure, or respiratory diseases were excluded. Cases (n = 45) had coronary artery disease (≥ 50% stenosis on angiography), while controls (n = 45) had no significant stenosis. Left atrial volume index (LAVI) was measured by echocardiography and classified as abnormal if ≥ 34 mL/m². All variables including LAVI were compared between two groups. Multivariate logistic regression was performed to investigate the role of variables in predicting CAD incidence in diabetic patients. RESULTS: A total of 90 patients with type 2 diabetes were included (45 with CAD and 45 without CAD); the mean age was 51.48±5.68 years, and 60% were male. Analyses revealed that LAVI values were significantly higher in patients with CAD compared to those without (P = 0.018), while there were no significant differences between two groups regarding gender, age, smoking, insulin dependence, diabetes duration, HbA1c, FBS, EF. also, no significant differences were observed in other echocardiographic measures including mild LVH, mild diastolic dysfunction, heart rate. Multivariate logistic regression identified LAVI as an independent predictor of CAD (OR = 1.24; 95% CI: 1.06-1.45), P = 0.006. ROC curve analysis showed that a LAVI cut-off of 28 mL/m² predicted CAD with 71% sensitivity and 51% specificity (P = 0.016). CONCLUSION: LAVI could be a potentially useful, accessible and practical index for screening CAD in diabetic patients. It may be proposed as part of the workup for the diagnosis and management of CAD in type 2 diabetic patients.

Discussion

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Cite This Study

Mahjoob et al. (2026) conducted a case-control in Type 2 diabetes mellitus undergoing coronary angiography (n=90). Left atrial volume index (LAVI) vs. Patients without significant coronary artery stenosis (<50%) was evaluated on Coronary artery disease (≥50% stenosis on coronary angiography) (OR 1.24, 95% CI 1.06-1.45, p=0.006). Left atrial volume index (LAVI) independently predicted coronary artery disease in normotensive type 2 diabetic patients (OR 1.24, 95% CI 1.06-1.45, P=0.006).

synapsesocial.com/papers/6af0db863c845ca7837ced1b https://doi.org/10.48305/arya.2026.45203.3051

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The association of left atrial volume index and coronary artery disease in type 2 diabetic patients without a history of hypertension and valvular heart disease.

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The association of left atrial volume index and coronary artery disease in type 2 diabetic patients without a history of hypertension and valvular heart disease.

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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