{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:10:02Z","timestamp":1788487802526,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Diabetic cardiomyopathy is a major contributor to cardiovascular morbidity, often progressing silently before overt heart failure. Left atrial (LA) strain, assessed via speckle-tracking echocardiography, could serve as an early indicator of subclinical myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM). Objectives: The objectives of this study were to evaluate LA strain parameters in patients with T2DM versus non-diabetic controls and investigate their association with glycemic control and diabetes duration. Methods: This cross-sectional study, designed according to STROBE reporting guidelines, included 47 participants (25 with T2DM and 22 controls) undergoing comprehensive echocardiographic and biochemical evaluation. LA reservoir (LASr), conduit (LAScd), and booster-pump (LASbp) strain values were measured. Associations with glycosylated hemoglobin (HbA1c) and diabetes duration were assessed via multivariate analysis. ROC curves were used to evaluate predictive performance. Results: Diabetic patients had significantly lower LASr (20.4 \u00b1 7.25% vs. 26.7 \u00b1 8.0%, p = 0.007), LAScd (\u221210.9 \u00b1 5.4% vs. \u221215.6 \u00b1 6.5%, p = 0.010), and LASbp (\u22129.9 \u00b1 4.2% vs. \u221212.9 \u00b1 5.0%, p = 0.034). LASr and LAScd remained independent predictors in multivariate models. ROC analysis showed good discrimination (AUC: LAScd = 0.78; LASr = 0.73). Conclusions: This study demonstrates that LASr and LAScd are independently associated with type 2 diabetes mellitus and can reliably identify subclinical atrial dysfunction before the onset of structural or symptomatic heart disease.<\/jats:p>","DOI":"10.3390\/jcdd12090369","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:11:01Z","timestamp":1758269461000},"page":"369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impaired Left Atrial Strain as an Early Marker of Cardiac Involvement in Type 2 Diabetes Mellitus: A Cross-Sectional Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Laura-C\u0103t\u0103lina","family":"Benchea","sequence":"first","affiliation":[{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"},{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I. M. Georgescu\u201d, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7925-3806","authenticated-orcid":false,"given":"Larisa","family":"Anghel","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"},{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I. M. Georgescu\u201d, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta","family":"Dubei","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2521-0917","authenticated-orcid":false,"given":"R\u0103zvan-Liviu","family":"Zanfirescu","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I. M. Georgescu\u201d, 700503 Ia\u0219i, Romania"},{"name":"Physiology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavril-Silviu","family":"B\u00eergoan","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"},{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I. M. Georgescu\u201d, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu Andy","family":"Sasc\u0103u","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"},{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I. M. Georgescu\u201d, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-4561","authenticated-orcid":false,"given":"Cristian","family":"St\u0103tescu","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700503 Ia\u0219i, Romania"},{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I. M. Georgescu\u201d, 700503 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","article-title":"Epidemiology of Type 2 Diabetes\u2014Global Burden of Disease and Forecasted Trends","volume":"10","author":"Khan","year":"2020","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_2","unstructured":"NCD Risk Factor Collaboration (NCD-RisC) (2024). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: A pooled analysis of 1108 population-representative studies with 141 million participants. Lancet, 404, 2077\u20132093. Erratum in Lancet 2025, 405, 1146."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Benchea, L.C., Anghel, L., Z\u0103voi, A., Chiuariu, T., Birgoan, S.G., Sasc\u0103u, R.A., and St\u0103tescu, C. (2024). 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