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Left atrial structural and functional remodelling study in type 2 diabetic patients in sub-saharan Africa: role of left atrial strain by 2D speckle tracking echocardiography.
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  • Alain Patrick Menanga,
  • Chris Nadège Nganou-Gnindjio,
  • André Jules Ahinaga,
  • Guy Sadeu Wafeu,
  • Lade Viche,
  • Daryl Nzokou ,
  • Jerome Boombhi,
  • Samuel Kingue
Alain Patrick Menanga
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1
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Chris Nadège Nganou-Gnindjio
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1
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André Jules Ahinaga
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1
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Guy Sadeu Wafeu
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1
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Lade Viche
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1
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Daryl Nzokou
University of Yaounde I Faculty of Medicine and Biomedical Sciences
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Jerome Boombhi
FMBS University of Yaounde 1
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Samuel Kingue
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1
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Abstract

Objective: To evaluate the role of peak atrial longitudinal strain (PALS) through speckle tracking 2D echocardiography for the assessment of structural and functional left atrial (LA) remodelling in a type 2 diabetes mellitus (T2DM) population. Methodology: We conducted a cross-sectional study during a 9-month period. Were included T2DM adults aged 18 and above. The variables assessed during the study include age and gender of participants, diabetes characteristics, cardiovascular risk factors, clinical anthropometric and haemodynamic parameters, standard echocardiographic parameters, volume-derived LA functions and 2D PALS. Results: We included a total of 102 patients. The mean age was 58±11.7 years and the M/F sex ratio was 1:1.5. Coexistent arterial hypertension (HTN) was observed in more than half (59.8%) of the population sample. Mean 2D PALS was 29.2±8.9% with 58.8% (95% CI:50.0–68.6) of subjects having a reduced LA strain (i.e.<32%). Reservoir and pump functions were the most altered LA volumetric phasic functions. Mean indexed LA maximal volume was 22.2±6.8 ml/m². There was a significant association between abnormal PALS and age, Body mass index (BMI), indexed LA volume, E/E’ ratio, LA active ejection fraction (pump function) and LA expansion index (reservoir function). Conclusion: LA remodelling is a recurrent condition in adult T2DM Cameroonians. The Reservoir and pump LA functions were the most affected. Assessment of LA global strain allows early detection of LA remodelling with comparison to LA size standard analyses. Age, BMI, indexed LA volume, E/E’ ratio, reservoir and pump LA functions were associated to 2D LA global strain impairment.

Peer review status:UNDER REVIEW

10 Jun 2020Submitted to Echocardiography
14 Jun 2020Submission Checks Completed
14 Jun 2020Assigned to Editor
27 Jun 2020Reviewer(s) Assigned
20 Aug 2020Review(s) Completed, Editorial Evaluation Pending
21 Aug 2020Editorial Decision: Revise Minor
04 Sep 20201st Revision Received
22 Sep 2020Submission Checks Completed
22 Sep 2020Assigned to Editor
22 Sep 2020Reviewer(s) Assigned