Early Detection of Left Atrial Dysfunction by Speckle Tracking Echocardiography in Asymptomatic Subjects with Type 1 Diabetes Mellitus

Background Incidence of type 1 diabetes mellitus (DM1) is expected to double in the next 20 years and the risk for developing heart failure and cardiovascular ischemic events is higher in this group of patients compared to healthy subjects. Diagnosis of cardiac pathology prior to clinical manifestations is crucial in patients with diabetes. Objectives The purpose of this study was to investigate by using measurements derived from conventional echocardiography and 2D-speckle tracking echocardiography (2D-STE) whether left atrial (LA) function is impaired in patients with DM1. Methods We included 43 young asymptomatic adults diagnosed with DM1 (mean interval from diagnosis 9 +/- 6 years) and 50 healthy young adults. 2D-STE was obtained using the GE Vivid S6 ultrasound machine and processed using the EchoPAC version 13.0 (GE Healthcare). Results There were no differences regarding LA volumes between the groups while LA strain during reservoir phase was significantly reduced in patients with DM1 compared to healthy subjects (p<0.01). Conclusions Young adults with DM1 without any known cardiovascular pathology display impaired LA function which may precede the development of diastolic dysfunction.