LEFT ATRIAL VOLUME INDEXATION IN PREDIABETES AND TYPE 2 DIABETES: WHY HEIGHT MATTERS
Lavdim IBRAIMI, Nikola JANEV, Marija BAJDEVSKA, Lejla SHABANI-MISINI, Emilija ANTOVA, Ljubica GEORGIEVSKA-ISMAIL
Abstract
Introduction: Overweight and obesity are major risk factors for left atrial volume (LAV) enlargement. Echocardiographic assessment of indexed LAV is essential for accurate evaluation diastolic function and risk stratification.
Objectives: To assess whether indexing LAV by height and height square offers better discrimination of LAV enlargement in pts with prediabetes (PDM) and type 2 diabetes mellitus (T2DM).
Methods: In 52 asymptomatic patients with T2DM and PDM, we performed conventional 2D echocardiography in addition to physical examination and laboratory analysis. LAV was measured using the area/length method and indexed by body surface area (BSA; LAVi), height (LAVh), and height squared (LAVh2).
Results: Among patients with T2DM, 48.8% were overweight and 43.9% were obese; among those with PDM, 27.3% were overweight and 45.5% were obese. There was a significant difference in the proportion of patients classified with dilated LAV depending on the indexing method used (BSA vs. height and height squared). Linear regression analysis showed that body mass index (BMI) was independent predictor of increased LAVi in T2DM patients and of increased LAVh and LAVh2 in those with PDM.
Conclusion: Indexing LAV by height or height squared results in significant reclassification of LAV from normal to dilated. This suggests that the current standard indexation method (BSA) may underestimate LAV dilation and potentially overlook patients at risk of diastolic dysfunction or future adverse cardiovascular events.
Pages: 216 - 225