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Paradoxical association between lipoprotein cholesterol levels and left atrial function in hypertensive diabetic patients: A speckle tracking study
Author(s) -
Kalaycıoğlu Ezgi,
Çetin Mustafa,
Kırış Tuncay,
Özyıldız Ali Gökhan
Publication year - 2021
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.23032
Subject(s) - medicine , cardiology , ejection fraction , speckle tracking echocardiography , atrial fibrillation , subclinical infection , ventricle , diabetes mellitus , apolipoprotein b , cholesterol , endocrinology , heart failure
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.