Left atrial phasic function and heart rate variability in asymptomatic diabetic patients.

Area of Science:

• Cardiology
• Diabetology
• Autonomic Nervous System

Background:

• Diabetes mellitus is a growing global health concern.
• Diabetic patients often exhibit subclinical cardiovascular damage.
• Cardiac autonomic dysfunction is a known complication of diabetes.

Purpose of the Study:

• To evaluate left atrial (LA) phasic function and heart rate variability (HRV) in asymptomatic type 2 diabetic patients.
• To investigate the relationship between HRV indices and LA function using echocardiography and speckle tracking.
• To identify early markers of cardiac damage in diabetes.

Main Methods:

• Cross-sectional study of 55 asymptomatic type 2 diabetic patients and 50 healthy controls.
• Comprehensive assessment including laboratory tests, 2D echocardiography, and 24-h Holter monitoring.
• Evaluation of LA volumes, emptying fractions (EF), and 2D strain analysis.

Main Results:

• Diabetic patients showed significantly altered LA volumes and reduced LA reservoir and conduit function (lower total and passive EF).
• Active LA EF was compensatory increased, and cardiac autonomic function (HRV) was significantly deteriorated in diabetics.
• HbA1c, LV mass index, and HRV were independently associated with LA reservoir function (total LA EF and longitudinal LA strain).

Conclusions:

• Diabetes significantly impacts LA phasic function and cardiac autonomic nervous system activity (HRV).
• HbA1c and HRV are independent predictors of LA reservoir function in diabetic patients.
• LA function and HRV are crucial markers for detecting preclinical cardiac damage and autonomic dysfunction in diabetes.