Paradoxical association between lipoprotein cholesterol levels and left atrial function in hypertensive diabetic patients: A speckle tracking study. Issue 7 (16th June 2021)

• Record Type: Journal Article
• Authors: Kalaycıoğlu, Ezgi; Çetin, Mustafa; Kırış, Tuncay; Özyıldız, Ali Gökhan
• Is Part Of: Journal of clinical ultrasound. Volume 49:Issue 7(2021)
• Page Start: 667
• Page End: 673
• Publication Date: 2021-06-16
• Subjects: hypertension -- left atrial mechanical function -- left atrium -- low‐density lipoprotein cholesterol -- two‐dimensional speckle‐tracking echocardiography; Ultrasonics in medicine -- Periodicals; 616.07543
• DOI: 10.1002/jcu.23032
• Languages: English
• ISSNs: 0091-2751

Abstract

Abstract: Background: Studies have shown that subclinical left atrial (LA) dysfunction can be diagnosed with two‐dimensional speckle tracking echocardiography (2D‐STE). Although low‐density lipoprotein cholesterol (LDL‐C) is a risk factor for cardiovascular diseases, recent studies have reported a paradoxical relationship between LDL‐C level and atrial fibrillation. In this study, we investigated the relationship between LDL‐C levels and LA function. Methods: In 168 patients with the diagnosis of hypertension and diabetes, transthoracic echocardiography with LA 2D‐STE was performed. The patients were then divided into two groups: normal LA‐strain ( n = 94) or impaired LA‐strain ( n = 74). The relationship between LDL‐C and LA function was analyzed. Results: Patients with impaired LA‐strain had higher body mass index (BMI) ( p = 0.029), higher statin usage ( p = 0.003), and lower LDL‐C levels ( p = 0.001) than patients with normal LA‐strain. They also had lower left ventricle ejection fraction (LVEF) ( p = 0.047) and higher E‐wave velocity (mitral e, m/s) ( p = 0.020). Multivariate logistic regression analysis showed that lower LDL‐C ( p = 0.034), higher BMI ( p = 0.004), lower LVEF ( p = 0.004), and higher E‐wave velocity ( p = 0.003) values were independently associated with impaired LA‐strain. The area under the receiver operating curve of LDL‐C in predicting impaired LA‐strain was 0.645 (0.564–0.730, p < 0.05). LDL‐C ≤ 112.5 mg/dl was found to be the optimal cut‐off value with 74.5% sensitivity and 51.2% specificity in predicting impaired LA strain. Conclusion: In patients with hypertension and diabetes, LDC‐C levels are moderately but independently and paradoxically associated with impaired LA function assessed by 2D‐STE.