Value of two-dimensional speckle tracking imaging in evaluating the changes of left atrial function in patients with pre-diabetes

WANG Min; YAO Yujuan; WANG Yao; ZHANG Pingyang

Abstract：Objective To evaluate the changes of left atrial longitudinal strain and strain rate in patients with prediabetes by two-dimensional speckle tracking imaging(2D-STI),and to explore its clinical application value.Methods 33 patients with prediabetes,33 patients with type 2 diabetes,and 35 healthy controls were selected as the study subjects.General labora-tory indicators and conventional ultrasound left heart parameters were recorded.Left atrial peak strain(SS)and systolic strain rate(s-SR),left atrial peak early diastolic strain rate(e-SR),and late diastolic strain rate(a-SR)were measured by 2D-STI.The parameters of the three groups were statistically compared and analyzed.Results 1)Compared with the healthy control group,SS,s-SR and e-SR were decreased in the prediabetic group,while,a-SR was increased,and the differences were sta-tistically significant[(35.14±2.39)%vs(30.71±3.06)%,(3.47±0.49)s-1 vs(3.02±0.45)s-1,(3.94±0.56)s-1 vs(3.22±0.61)s-1,(3.22±0.50)s-1 vs(3.58±0.48)s-1,P＜0.05];2)Compared with the healthy control group,the E value decreased,the A value increased,the E/A value decreased,SS,s-SR and e-SR decreased significantly,and a-SR increased.These differences were statistically significant[(88.63±6.84)cm/s vs(84.88±6.85)cm/s,(62.19±5.26)cm/s vs(64.90±2.54)cm/s,1.44±0.18 vs 1.31±0.13,(35.14±2.39)%vs(26.45±2.69)%,(3.47±0.49)s-1 vs(2.65±0.36)s-1,(3.94±0.56)s-1 vs(2.42±0.58)s-1,(3.22±0.50)s-1 vs(3.61±0.73)s-1,P<0.05];and 3)Compared with the pre-diabetic group,the decrease of SS,s-SR and e-SR was more obvious in the diabetic group[(30.71±3.06)%vs(26.45±2.69)%,(3.02±0.45)s-1 vs(2.65±0.36)s-1,(3.22±0.61)s-1 vs(2.42±0.58)s-1,P<0.05],but there was no significant difference in a-SR.The results indicated that the left atrial myocardial reserve and duct function of pre-diabetic patients had begun to de-crease,and became worse with the progression of diabetes.The left atrial pump function had increased compensatory in the early stage.Conclusion The changes of left atrial myocardial function in prediabetic patients possess the characteristic,2D-STI can detect and evaluate the changes sensitively.