Abstract 14742: Impact of Albuminuria on Left Atrial Function Mediated by Left Ventricular Longitudinal Function in Patients With Diabetic Mellitus
Background: Diabetic nephropathy is independently associated with left ventricle (LV) longitudinal systolic myocardial dysfunction in asymptomatic diabetes mellitus (DM) patients with preserved LV ejection fraction (LVEF). However, the impact of diabetic nephropathy on left atrial (LA) function remains unknown.
Methods: We studied 198 asymptomatic DM patients, all of whom had preserved LVEF without coronary artery disease. Diabetic nephropathy was defined as having a protein level higher than for micro-albuminuria. LV global longitudinal strain (GLS) and LA strain were analyzed by measuring two-dimensional speckle-tracking longitudinal strain. Sixty-nine age-, gender-, LVEF-matched normal subjects were also studied.
Results: GLS and LA strain in systole (LAS-s) decreased significantly from normal controls to DM patients without (n=137) and with nephropathy (n=61), in that order. Furthermore, GLS, LAS-s, and LA strain in late diastole (LAS-a) were significantly lower in DM patients with macro-albuminuria (n=19) than in those with micro-albuminuria (n=42). While one multivariate regression analysis identified albuminuria as an independent determinative factor of LAS-s among other relevant clinical background factors (β=-0.16, p=0.002), another multivariate regression model for LAS-s plus GLS (β=0.40, p<0.001) showed that albuminuria was not a significant factor (β=-0.02, p=0.68). Similarly, another multivariate regression model including GLS (β=0.32, p<0.001) demonstrated that clinical features relevant for LAS-a, except for age, were not independent determinants of LAS-a.
Conclusions: LA reservoir and contractile function are more impaired in DM patients than in those without albuminuria. The cross-linked association of LA strains with GLS and albuminuria may thus be important for better understanding the development of diabetic cardiomyopathy.
Author Disclosures: Y. Mochizuki: None. H. Tanaka: None. H. Takada: None. F. Soga: None. K. Dokuni: None. Y. Hatani: None. K. Hatazawa: None. H. Matsuzoe: None. H. Shimoura: None. J. Ooka: None. H. Sano: None. K. Ryo - Koriyama: None. K. Matsumoto: None. K. Hirata: None.
- © 2016 by American Heart Association, Inc.