Assessment of Left Atrial Function in Atrial Fibrillation Patients with Diabetes Mellitus

Open Access

Abstract

Background: Atrial fibrillation and diabetes mellitus commonly coexist and may accelerate left atrial remodeling, cause impaired atrial function (CHADS2 score, CHA2DS2-VASc score, NT-proBNP) and increase cardiovascular risk. Methods & Materials: This cross-sectional study was conducted at the Department of Medicine, Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh from 16 March 2025 to 15 March 2026. The study included 120 adult patients with atrial fibrillation and diabetes mellitus. Data were analyzed using SPSS version 26.0, with p<0.05 considered statistically significant. Results: Among 120 atrial fibrillation patients with diabetes mellitus, the mean age was 61.8 ± 9.6 years, and 65.0% were male. Hypertension was present in 76.7%, and uncontrolled diabetes, HbA1c ≥7.0%, was observed in 71.7%. The mean CHADS2 and CHA2DS2-VASc scores were 2.8 ± 1.2 and 4.1 ± 1.4, respectively, while the median NT-proBNP level was 860 pg/mL, IQR 420-1850. Impaired left atrial function was found in 82 patients (68.3%). Compared with preserved LA function, impaired LA function was associated with older age (64.1 ± 9.2 vs 56.9 ± 7.8 years), longer diabetes duration (10.4 ± 5.2 vs 6.8 ± 3.9 years), higher HbA1c (8.6 ± 1.5% vs 7.4 ± 1.1%), higher CHA2DS2-VASc score (4.5 ± 1.3 vs 3.2 ± 1.1), higher NT-proBNP (1280 vs 410 pg/mL), larger LAVI (46.9 ± 10.7 vs 33.4 ± 6.8 mL/m²), and lower LA reservoir strain (12.7 ± 4.2% vs 22.4 ± 3.7%), all statistically significant. Increased LAVI ≥34 mL/m², OR of 5.64 (95% CI 2.15-14.79, p<0.001) and NT-proBNP ≥900 pg/mL, OR 4.21 (95% CI 1.82-9.74, p=0.001) were the strongest independent predictors of impaired LA function. Conclusion: Impaired left atrial function was common among atrial fibrillation patients with diabetes mellitus and was associated with higher CHADS2 and CHA2DS2-VASc scores, raised NT-proBNP, poor glycemic control, longer diabetes duration, and increased left atrial volume.