INTRODUCTION

The left atrium (LA) is not only a simple passive transport chamber but also a dynamic apparatus that plays an important role in cardiac function by adjusting left ventricular filling through its reservoir, conduit, and contractile functions. LA remodelling refers to the spectrum of pathophysiological changes in atrial structure and mechanical function, and within the electric, ionic, and molecular environments of the LA. This remodelling most often occurs in response to stresses imposed by conditions such as hypertension, heart failure, type 2 diabetes mellitus (T2DM), and obesity 1. Remodelling constitutes the basis of atrial cardiomyopathy. It has been recently defined by an expert consensus as a complex of structural, architectural, contractile or electrophysiological modifications affecting the atria with the potential of inducing significant clinical manifestations 2. It has also been identified as an independent predictor of adverse cardiovascular event in T2DM, a pathology whose prevalence is constantly increasing in sub-Saharan Africa 3,4
Analysis of LA size through standard echocardiographic methods is commonly used but has proven to be inaccurate in the assessment of LA remodelling 5. They are subjective, depend on the level of expertise of the operator, lack sensibility in detecting early abnormalities and do not apprehend all the components of myocardial function 6. Bidimensional speckle tracking echocardiography allow a direct and angle-independent analysis of myocardial deformation, thus giving sensitive and reproductible myocardial dysfunction indices which overcome the limits of Doppler-derived measurements 7. Evaluation of LA deformation mechanics could help in detecting LA dysfunction earlier than the standard measurement methods 8.
This study aims to evaluate the role of peak atrial longitudinal strain through speckle tracking 2D echocardiography for the assessment of structural and functional LA remodelling in a T2DM adult population in Cameroon.