The assessment of atrial electromechanic coupling time by using tissue Doppler imaging in patients with type 2 diabetes mellitus

Determination of atrial electromechanical coupling time interval by tissue Doppler imaging in diabetic patients may provide important information about the pathophysiology of diabetes mellitus-atrial fibrillation relationship. Twenty two healthy individuals (Control group; Group 1), 27 patients with diabetes mellitus of < years’ duration (Group 2) and 18 patients with diabetes mellitus of ≥5 years’ duration (Group 3) were enrolled in the study. Time intervals from the beginning of electrocardiographic p wave to the onset and peak of atrial contraction waves obtained via lateral and septal left atrial walls were measured by using color tissue Doppler imaging from the apical four chamber view. These time intervals were defined as atrial electromechanical coupling intervalbegin (AECI begin) and AECIpeak. Moreover, mitral inflow velocities by pulsed-wave Doppler (E wave, A wave and E deceleration time) and annular velocities by color tissue Doppler imaging (S’, E’, A’) were also measured. There were no significant differences among the groups in terms of AECIbegin and AECIpeak. However, septal mitral annular E’ wave velocity was significantly lower in Group 3 compared to the other groups. In addition, lateral mitral annular E’ wave velocity was significantly lower in Group 3 compared to Group 1. Although we were not able to find any significant differences for both AECIbegin and AECIpeak values among the groups, we demonstrated that myocardial diastolic functions were significantly impaired in patients with diabetes of long duration as reflected by lower E’ velocities and increased E/E’ ratios.