APPLICATION VALUE OF FOUR-DIMENSIONAL LEFT ATRIAL STRAIN IN EVALUATING THE LEFT VENTRICULAR DIASTOLIC FUNCTION OF T2DM

Yang Wang¹, Siyuan Cui², Chunyuan You^{1, *}

¹Department of Echocardiography, Wuxi No.2 People’s Hospital, China - ²Department of Endocrinology, Wuxi No.2 People’s Hospital, China

Introduction: Exploring the application value of four-dimensional (4D) left atrial strain in evaluating the diastolic function of left ventricle for patients with type 2 diabetes mellitus (T2DM).

Methods: A total of 90 T2DM patients diagnosed at China Wuxi No.2 People’s Hospital from 2019 to 2021 were analyzed. According to the ASE/EACAI guideline for evaluating the left ventricular diastolic function, three groups were designed: Normal group (DD0, n=57), Undetermined group (DDU, n=13) and left ventricular diastolic dysfunction (LVDD) group (DD1, n=20). Comparing the differences in 4D left atrial strain during the reservoir phase (LASr), conduit phase (LAScd) and contraction phase (LASct) among these groups, further discussing the diagnostic accuracy of LASr, LAScd and LASct, then combined with the traditional parameters to assess patients' left ventricle diastolic function with T2DM.

Results: The 4D LASr and LAScd showed good diagnostic values in predicting LVDD in T2DM patients. The diagnostic accuracy of LASr was better than LAScd (the areas under curves: 0.907 vs 0.786, P<0.001). The detection rate of traditional method combined with LASr was higher than traditional method alone (22.2% vs 30.0%, P=0.016). The correlations between LASr and average E/e’, LASr and lateral e’, LASr and septal e’ were significant (r=-0.597, 0.511 and 0.515, P<0.001).

Conclusion: 4D LASr is a reliable way to evaluate the diastolic function of the left ventricle for T2DM patients. For patients who are undetermined, LASr can be the supplemental parameter for a higher detection rate. Higher average E/e’ and lower e’ suggest more severe LVDD.