Related Experiment Video
Updated: Jul 12, 2025
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Assessment of left atrioventricular coupling and left atrial function impairment in diabetes with and without
Rui Shi1, Yi-Ning Jiang1, Wen-Lei Qian1
1Department of Radiology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
Insights
Hypertension worsens left atrial function and alters atrioventricular coupling in diabetes mellitus patients. This study highlights how co-occurring conditions impact cardiac health, emphasizing the need for comprehensive management.
Area of Science:
- Cardiology
- Diabetology
- Hypertension Research
Background:
- Diabetes Mellitus (DM) and hypertension are prevalent comorbidities.
- Both conditions are associated with cardiovascular complications.
- The combined impact on left atrial (LA) function and atrioventricular coupling is not fully understood.
Purpose of the Study:
- To evaluate the effect of co-occurring diabetes mellitus (DM) and hypertension on left atrial (LA) function and left atrioventricular coupling index (LACI).
- To compare these effects in patients with DM plus hypertension (DM+HP) versus DM only (DM-HP).
Main Methods:
- Cardiac magnetic resonance (CMR) was used to assess 176 DM patients.
- Patients were divided into DM+HP (n=103) and DM-HP (n=73) groups.
- Evaluated parameters included LA reservoir, conduit, and booster-pump function, LA volume index (LAVI), LV global longitudinal strain (LVGLS), and LACI.
Main Results:
- The DM+HP group showed significantly lower total LAEF and active LAEF compared to the DM-HP group.
- DM+HP patients exhibited reduced LA reservoir (εs), conduit (εe), and booster (εa) strains, alongside an increased LACI.
- Multivariate analysis indicated hypertension independently contributes to decreased LA booster strain (εa) and increased LACI in DM patients.
Conclusions:
- Hypertension exacerbates the decline in LA booster strain and increases LACI in patients with DM.
- LV GLS is significantly associated with LA phasic strain in DM patients.
- These findings suggest potential alterations in atrioventricular coupling due to the combined presence of DM and hypertension.
Purpose:
The study was designed to assess the effect of co-occurrence of diabetes mellitus (DM) and hypertension on the deterioration of left atrioventricular coupling index (LACI) and left atrial (LA) function in comparison to individuals suffering from DM only.
Methods:
From December 2015 to June 2022, we consecutively recruited patients with clinically diagnosed DM who underwent cardiac magnetic resonance (CMR) at our hospital. The study comprised a total of 176 patients with DM, who were divided into two groups based on their blood pressure status: 103 with hypertension (DM + HP) and 73 without hypertension (DM-HP). LA reservoir function (reservoir strain (εs), total LA ejection fraction (LAEF)), conduit function (conduit strain (εe), passive LAEF), booster-pump function (booster strain (εa) and active LAEF), LA volume index (LAVI), LV global longitudinal strain (LVGLS), and LACI were evaluated and compared between the two groups.
Results:
After adjusting for age, sex, body surface area (BSA), and history of current smoking, total LAEF (61.16 ± 14.04 vs. 56.05 ± 12.72, p = 0.013) and active LAEF (43.98 ± 14.33 vs. 38.72 ± 13.51, p = 0.017) were lower, while passive LAEF (33.22 ± 14.11 vs. 31.28 ± 15.01, p = 0.807) remained unchanged in the DM + HP group compared to the DM-HP group. The DM + HP group had decreased εs (41.27 ± 18.89 vs. 33.41 ± 13.94, p = 0.006), εe (23.69 ± 12.96 vs. 18.90 ± 9.90, p = 0.037), εa (17.83 ± 8.09 vs. 14.93 ± 6.63, p = 0.019), and increased LACI (17.40±10.28 vs. 22.72±15.01, p = 0.049) when compared to the DM-HP group. In patients with DM, multivariate analysis revealed significant independent associations between LV GLS and εs (β=-1.286, p < 0.001), εe (β=-0.919, p < 0.001), and εa (β=-0.324, p = 0.036). However, there was no significant association observed between LV GLS and LACI (β=-0.003, p = 0.075). Additionally, hypertension was found to independently contribute to decreased εa (β=-2.508, p = 0.027) and increased LACI in individuals with DM (β = 0.05, p = 0.011).
Conclusions:
In DM patients, LV GLS showed a significant association with LA phasic strain. Hypertension was found to exacerbate the decline in LA booster strain and increase LACI in DM patients, indicating potential atrioventricular coupling index alterations.
More Related Videos
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation