Left atrial strain as an additional parameter for assessing diastolic dysfunction in young adults with metabolic syndrome

The aim of this article is to evaluate the parameters of left atrial (LA) strain in 2D and 4D modes and to identify early markers of diastolic dysfunction in young subjects (aged 18 to 44) with the first clinical and laboratory diagnosis of metabolic syndrome (MS) according to the criteria of the International Federation of Diabetologists (IDF). All subjects underwent transthoracic echocardiography (EchoCG) to study structural and functional changes in the myocardium, with an assessment of LA strain in 2D and 4D modes. In the work we determined markers of LV dysfunction using Speckle tracking technology, and also investigated correlations between the main components of MS and echocardiographic parameters. Using comparative analysis, the main group showed statistically lower values of LА strain during reservoir and conduit phases in 2D-mode compared to the control group. LА strain during the reservoir phase (LASr) in 2D combined with standard parameters of left ventricular diastolic function such as LASr/(VE/e’mean), VE/LASr also had significant differences in subjects with MS. Components of MS such as obesity (body mass index, waist circumference), arterial hypertension (elevated systolic blood pressure), dyslipidemia (hypertriglyceridemia) and glycemia had moderate negative correlations with LASr in 2D when identifying a group of patients with LA strain during the reservoir phase of less than 43.5%, based on the lower quartile of healthy individuals.