2型糖尿病患者左心室不同舒张功能状态下左心房结构变化

Changes of left atrial structure under different left ventricular diastolic functions in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者左心室不同舒张功能状态下左心房结构变化。方法采用三维超声心动图和斑点追踪显像检查75例T2DM患者(A组)和30例健康人(B组)左心房结构相关参数。A组分为左心室舒张功能正常(A1组,18例)、左心室舒张功能轻度降低(A2组,40例)和假性正常化/限制性舒张功能障碍(A3组,17例)三个亚组,比较各组心功能参数。结果与B组比较,A组左心房容积指数增大、左心房收缩期整体应变峰值(S)和左心室舒张晚期左心房应变率峰值(SRa)下降(P<0.05)。A1组S和SRa低于B组[(24.76±14.98)%vs.34.91±16.54)%和(1.22±0.42)s-1 vs.(1.59±0.58)s-1](P<0.05)。A2组S和SRa为(35.65±19.71)%和(1.53±0.57)s-1,高于A1组(P<0.05)。A3组S和SRa为(16.66±9.82)%和(0.94±0.48)s-1,均低于A1组和B组(P<0.05)。结论 T2DM可引起左心室舒张功能障碍,促进左心房功能恶化。

Objective To investigate the changes of left atrial（LA）structure under different left ventricular（LV）diastolic functions in the patients with type 2diabetes mellitus（T2DM）.Methods The left atrial（LA） structure-related parameters were examined with three dimensional echocardiography and speckle-tracking imaging in 75 T2DM patients（group A）and 30healthy controls（group B）.On the basis of LV diastolic function,the patients in group A were subdivided into three groups of A1（with normal LV diastolic function,18cases）,A2（with reduced LV diastolic function,40cases）and A3（with normalization of pseudo-or restrictive diastolic dysfunction,17cases）.The parameters were compared among those groups.Results LA volume index was higher,but whole LA systolic peak strain（S）and peak late diastolic strain rate（SRa）were lower in group A than those in group B（P〈0.05）.The S and SRa in group A1were lower than those in group B[（24.76±14.98）%vs.（34.91±16.54）% and（1.22±0.42）s-1 vs.（1.59 0.58）s-1]（P〈0.05）.The S and SRa in group A2were（35.65±19.71）% and（1.53±0.57）s-1,which were higher than those in group A1（P〈0.05）.The S and SRa in group A3were（16.66±9.82）%and（0.94±0.48）s-1,which were lower than those in groups of A1and B（P〈0.05）.Conclusion T2DM may cause LV diastolic dysfunction and promote deterioration of LA function.