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.