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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 structural changes of left atrium in patients with type 2 diabetes mellitus (T2DM) under different diastolic function. Methods The left atrial structural parameters of 75 T2DM patients (group A) and 30 healthy subjects (group B) were examined by three-dimensional echocardiography and speckle tracking imaging. In group A, left ventricular diastolic function was normal (group A1, n = 18), mild left ventricular diastolic function (group A2, n = 40) and pseudo-normalization / restrictive diastolic dysfunction A subgroup, comparing the parameters of cardiac function. Results Compared with group B, the left atrial volume index of group A increased, the peak value of total strain of left atrial systole (S) and the amplitude of left atrial peak (SRa) of left ventricular diastolic phase decreased (P <0.05). S and SRa in A1 group were lower than those in B group [(24.76 ± 14.98)% vs.34.91 ± 16.54% and (1.22 ± 0.42) s-1 vs. (1.59 ± 0.58) s -1), respectively. The S and SRa in group A2 were (35.65 ± 19.71)% and (1.53 ± 0.57) s-1, respectively, which were higher than those in group A1 (P <0.05). The S and SRa in group A3 were (16.66 ± 9.82)% and (0.94 ± 0.48) s-1, respectively, which were lower than those in group A1 and group B (P <0.05). Conclusions T2DM can induce left ventricular diastolic dysfunction and promote the deterioration of left atrial function.