Diabetes mellitus (DM) is a frequent disease, it's a risk factor of coronary artery disease, heart failure and atrial fibrillation. In the current study, we aimed to evaluate left atrial (LA) volume and function as assessed by strain and strain rate derived from 2D speckle tracking in patients with DM and with normal left atrial size.

Thirty patients with type 2 DM (DM group) were compared to 30 age- and gender-matched normal controls. The maximum LA indexed volume, conventionnel measures of atrial function, 2D strain (PALS: Peak atrial longitudinal strain during the reservoir period and PACS: Peak atrial contraction strain during late diastole) and strain rate (SR-s: during systole, SRe early diastole, SRa: late diastole) were analysed and compared in the two groups.

The LA indexed volume (LAVI) was larger in DM group that in normal controls (31.1±2.8 vs. 25.3±3.4ml/m², P<0.0001). PALS was significantly reduced in the DM group (22.5±8.67 vs. 40.3±3.15%; P<0.0001). SR-s was also impaired in DM group (1.2±0.4 vs. 1.6±0.4, P=0.00). No difference were found between the two groups concerning PACS, SRe and SRa. In DM group, There was a correlation between LAVI and PALS with increasing grades of diastolic dysfunction (r=0.28, P<0.001 and r=−0.46, P=0.03, respectively). A negative correlation between PALS and glycated hemoglobin level and diabetes duration was found (r=−0.42, P=0.001 and r=−0.52, P<0.000, respectively) (Fig. 1).

Strain and strain rate imaging may be considered a promising tool for the early detection of LA function impairment in patients with type 2 DM. This LA dysfunction is correlated to glycated hemoglobin level, diabetes duration and grades of diasolic dysfunction.