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| Two-dimensional speckle tracking imaging in evaluating left atrial function and predicting prognosis of diabetics complicating acute coronary syndrome |
| ZHOU Cuicui1, ZUO Tieniu2, WANG Zhongqun1, FAN Tingpan1, XU Liangjie1 |
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Abstract Objective To investigate the value of left atrial function related indexes in predicting the prognosis of diabetics with acute coronary syndrome (ACS) and their improvements of left ventricular function. Methods We selected 142 diabetics complicating ACS (ACS group) and 67 diabetics without ACS (control group). Each echocardiographic parameter was collected by using GE Vivid E9 echocardiography and twodimensional speckle tracking imaging (2D-STI) technology. The mortality, incidence of major adverse cardiovascular events (MACEs), and echocardiographic parameters were followed up one day, and 3, 6, 9, 12 and 18 months after operation. According to the level of left ventricular ejection fraction (LVEF) 18 months after operation compared with LVEF one day after operation, the ACS group were divided into good recovery group (n=77) and poor recovery group (n=65). The echocardiographic parameters were compared among the three groups. The receiver operating characteristic (ROC) curves were applied to analyze the predictive value of left atrial function for MACEs. ResultsAccording to the order of small to large, the left atrial strain and strain rate in systolic and early diastolic phase of left ventricle are sequenced as poor recovery group, good recovery group and control group, with statistically significant differences (P<0.05); in the ACS group, the left atrial strain and strain rate in late diastolic phase are significantly higher than those in the control group (P<0.05), but there is no significant difference between the good recovery group and poor recovery group (P>0.05). ROC curve analysis indicates that the area under curve of left atrial systolic strain (LAs-s) in predicting LVEF recovery is the largest. According to the cut-off value of LAs-s (20.15%), the enrolled patients are divided into low LAs-s group and high LAs-s group, and the survival curve is drawn. The incidence of endpoint events is lower in high LAs-s group than that in the low LAs-s group. Conclusion Left atrial strain and strain rate can be employed in predicting the prognosis of diabetes complicated by ACS.
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