Korean J Intern Med.  2017 Mar;32(2):286-294. 10.3904/kjim.2014.380.

Atrial conduction times and left atrial mechanical functions and their relation with diastolic function in prediabetic patients

• Gudul NE
• Karabag T
• Sayin MR
• Bayraktaroglu T
• Aydin M

• KMID: 2371651
• DOI: http://doi.org/10.3904/kjim.2014.380

Abstract

BACKGROUND/AIMS
The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT).
METHODS
Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of the P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated.
RESULTS
The mitral E/A and E"²/A"² ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E"²/A"².
CONCLUSIONS
In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients.

Keyword

Prediabetic state; Atrial fibrillation; Left atrial mechanical function; Electromechanical delay; Diastolic function

MeSH Terms

Adult
Atrial Fibrillation
Echocardiography, Doppler
Electrocardiography
Fasting
Female
Glucose
Humans
Male
Methods
Prediabetic State
Glucose