Association Between Left Atrial Volume Index (LAVI) and Glycemic Control (HbA1c) in Patients With Atrial Fibrillation and Type 2 Diabetes Mellitus.

BACKGROUND

Glycemic control and left atrial remodeling in patients with concomitant type 2 diabetes mellitus (T2DM) and atrial fibrillation (AF) remain unclear. In this study, we examined the association between glycated hemoglobin (HbA1c) and left atrial volume index (LAVI) in this high-risk population.

METHODS

A total of 700 patients with AF and T2DM were included in this retrospective study. We used medical records to obtain HbA1c and echocardiographic parameters. We assessed LAVI as a continuous variable and as a binary variable (enlarged LAVI > 34 mL/m²). We used Spearman correlation, multivariable linear regression, and binary logistic regression to examine the relationship between HbA1c and LAVI.

RESULTS

There was a significant association between higher HbA1c and greater LAVI (Spearman's ρ = 0.287, p < 0.001). After multivariable adjustment, each 1% increase in HbA1c was associated with a 1.678 mL/m² increase in LAVI. Higher HbA1c was independently associated with increased odds of enlarged LAVI (adjusted odds ratio (OR) = 1.701, 95% confidence interval (CI): 1.391-2.081, p < 0.001). Hypertension, heart failure, and chronic kidney disease were also independently associated with enlarged LAVI.

CONCLUSION

In patients with concurrent AF and T2DM, higher HbA1c was independently associated with larger LAVI and higher odds of left atrial enlargement (LAE). Future prospective studies are warranted to determine whether improved glycemic control can influence atrial remodeling.