P409Relationship between diastolic function and left atrial volume in a cohort of well controlled type 2 diabetic patients

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Purpose: the left atrial (LA) volume has been proposed as a marker of chronic diastolic dysfunction providing prognostic information incremental to clinical data and conventional measures of left ventricular (LV) systolic and diastolic function in various pathological conditions. However, the determinants of LA volume in well controlled type II diabetic (T2DM) have never been investigated in great detail.Methods: 50 consecutive type 2 diabetic patients were studied (mean age 67.6±5.1 years, male 76%, haemoglobin A1c 7.3±0.8%, ejection fraction 72.8±7.1%). All patients underwent a complete echocardiographic-Doppler evaluation with tissue Doppler (TDI) analysis and the mean between septal and lateral mitral annular velocity were calculated. E/e' ratio was also derived. End-diastolic pressure (EDP) was estimated as 11.96+0.596 • E/e'.Results: mean diabetes duration was 11.9±8.0 years, mean LA volume index was 26.4±8.8 ml/ m2, mean s' annular velocity was 9.8±1.5 m/s, mean e' annular velocity was 8.8±1.8 m/s, mean E/e' ratio was 7.0 ±1.6, mean EDP was 16.0 ±1.3 mmHg and mean LV mass index was 111.0±17.2 g/ m2. Univariate predictors of LA volume index were s' annular velocity (r= -0.34, p=0.02), E/e' ratio (r= 0.46, p=0.001), EDP (r=0.38, p=0.01) and LV mass index (r= 0.32, p= 0.03). In a first multiple regression model E/e' (p=0.02) predicted LA volume index independently of LV mass index (p=0.2), age (p=0.8) and diabetes duration (p=0.7). In a second model E/e' (p=0.03) predicted LA volume independently of s' velocity (p=0.5), haemoglobin A1c (p= 0.7) and diabetes duration (0.5). E/e' was also significantly related to haemoglobin A1c (r=0.35, p=0.01).Conclusions: in well controlled type 2 diabetic patients the E/e' ratio, an index of LV filling pressure, related to the degree of glycemic control and predicted LA volume independently of other clinical and hemodynamic potential confounders

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