Impact of abnormal glucose metabolism on left atrial morphology and function

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K20707
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 90130:Medical systems-related
• Research Institution: The University of Tokyo
• Principal Investigator: Nakanishi Koki 東京大学, 医学部附属病院, 助教 (80835140)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 左房機能 / スペックルトラッキング心エコー / 心房細動 / 糖尿病 / 耐糖能異常

Outline of Final Research Achievements

We aimed to investigate the exact prevalence of abnormal glucose metabolism, and its impact on left atrial (LA) remodeling and reversibility in patients with atrial fibrillation (AF). The major findings of the present study were as follows: (i) approximately 65% of patients with AF who underwent first catheter ablation (CA) had abnormal glucose metabolism including impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and diabetes mellitus (DM), (ii) patients with DM had significantly impaired LA function, while similar LA morphology and function were observed between the IGT/IFG group and the normal glucose tolerance (NGT) group, and (iii) IGT/IFG as well as DM carried significant risk for lack of LA reverse remodeling after CA.

Free Research Field

心エコー、心機能解析、不整脈、メタボリックシンドローム

Academic Significance and Societal Importance of the Research Achievements

心房細動患者における65%で糖代謝異常が観察された。糖尿病の存在は術前左房機能低下の独立した危険因子であった。一方、耐糖能異常/空腹時高血糖群は、ベースラインの左房指標に正常糖代謝群と比較して有意な差は認められなかったが、アブレーション後の左房リバースリモデリングには有意な差が観察された。今回の結果は糖代謝異常例における心房細動の病態理解や治療戦略に重要な情報を提供するものと考えられた。