الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 100 |  |  |
| | | from | 100 | | |
Abstract
LA is a chamber with multiple functions (i.e., reservoir, conduit, and contraction) that interacts with the LV to the latter chamber fills and sends blood to circulation.
STE allows direct and angle independent analysis of myocardial deformation, thus giving sensitive and reproducible myocardial dysfunction indices which overcome the limits of Doppler-derived measurements, so evaluation of LA deformation mechanics could help in detecting LA dysfunction earlier than the standard measurement methods, although these techniques are simple and easy to perform, their sensitivity is low.
STE is a noninvasive ultrasound imaging technique that allows an objective and quantitative evaluation of global and regional myocardial function independently from the angle of insonation and from cardiac translational movements, the atrial longitudinal strain deriving from the application of the analysis of myocardial deformation using STE.
So, our study aimed to evaluate left atrial functions, by STE in diabetic patients with CAD.
To elucidate our results, this was a cross section study was conducted on 50 patients of diabetic patients with CAD and 20 subjects as a control group, were selected from Cath lab, Menoufia University Hospital during the period from October 2020 to August 2021.
2D echocardiography, M-mode and Doppler examination were performed; LA, Ao and LV dimensions were measured including LVEDD, LVESD, IVSD, LVPWD, LV mass and LVEF, Pulsed-wave Doppler echocardiography was performed for measuring mitral and tricuspid inflow velocity.
All patients were selected according to the inclusion and exclusion criteria: Inclusion criteria: patients >18 years, patient known to be diabetic and those Controlled ones, chest pain with CAD patients and LVEF > 50%. Exclusion criteria: Patients known to be cardiomyopathic, patients with pericardial disease, any type of arrhythmias especially atrial fibrillation, chronic liver disease, chronic kidney disease and patient with core pulmonale disease.
All participants included in our study were subjected to the following: age, gender, smoking, height, weight, and BMI, also, clinical examination and laboratory investigation involving serum glycosylated hemoglobin (HbA1c) and lipid profile (total cholesterol, TG, LDL, HDL).
Standard 12-lead electrocardiogram:
Coronary angiography:
significant coronary lesions were identified by appearance of stenosis of ≥ 50% diameter decrease.
Echocardiographic study: Speckle tracking echocardiography:
Traditional 2D grey scale echocardiography with ECG recording was used to provide apical four and two chamber views, three consecutive cardiac cycles were caught and averaged, with the frame degree established between 60 and 80 frames per second.
Summary
73
Results can be summarized as follow:
There were highly significant differences between the studied groups regarding
smoking and diabetes type (P< 0.001). While, gender, height, weight, BMI, HR,
hypertensive, HDL and HbA1C%, AOD, LVEDD, LVESD, LVEDV, LVESV, LVEF
and LA.CSI % didn’t show any significant differences between the studied groups (P>
0.05).
Age, total cholesterol, triglycerides, LDL, LAD, mitral A and E/E Ratio were
significantly increased among patient group (DM+ CAD) than control group (p< 0.05).
Average GLS, mitral E/A ratio, E average, PALS %, PACS%, Post A % for 4CH,
Septal E and lateral E were significantly increased among control group than patient
group (DM+ CAD) (p<0.05).
There were significant positive correlations between PALS with HbA1c%, E (septal,
lateral and average). While there was significant negative correlation between PALS
with E/E Ratio and LA volume index (P<0.001).
There were significant positive correlations between PACS with HbA1c%, mitral E/A
ratio, E lateral, PALS and LA CSI. While there was significant negative correlation
between PACS with Mitral A and LA volume index (P<0.05).
There were significant positive correlations between Post A with BMI and LVEDD
(P< 0.05).
There were significant positive correlations between LA CSI with HbA1c % and
PACS. While, there was significant negative correlation between LA CSI with Mitral
A (P<0.05).