ARYA Atherosclerosis Journal

The association of left atrial volume index and coronary artery disease in type 2 diabetic patients without a history of hypertension and valvular heart disease

Document Type : Original Article

Authors

Mohammad Parsa Mahjoob 1
Roxana Sadeghi 2
Mohammad Haji Aghajani 2
Fatemeh Omidi 1
Mostafa Rostamnezhad 3
Mohadese Salehi 2

1 Department of Cardiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.48305/arya.2026.45203.3051
Abstract
BACKGROUND: Left atrial volume index (LAVI) evaluated using echocardiography serves a powerful predictor of cardiovascular outcomes. Since type 2 diabetes mellitus (T2DM) is a main risk factor for coronary artery disease (CAD), the present investigation was conducted to examine the association between LAVI and incidence of CAD in diabetic patients.
METHODS: In this case-control study, 90 type 2 diabetic patients aged 18–70 years who underwent coronary angiography at Imam Hossein Hospital, Tehran, between 2023 and 2024 were consecutively enrolled. Patients with hypertension, valvular heart disease, heart failure, or respiratory diseases were excluded. Cases (n = 45) had coronary artery disease (≥ 50% stenosis on angiography), while controls (n = 45) had no significant stenosis. Left atrial volume index (LAVI) was measured by echocardiography and classified as abnormal if ≥ 34 mL/m². All variables including LAVI were compared between two groups. Multivariate logistic regression was performed to investigate the role of variables in predicting CAD incidence in diabetic patients.
RESULTS: A total of 90 patients with type 2 diabetes were included (45 with CAD and 45 without CAD); the mean age was 51.48±5.68 years, and 60% were male. Analyses revealed that LAVI values were significantly higher in patients with CAD compared to those without (P = 0.018), while there were no significant differences between two groups regarding gender, age, smoking, insulin dependence, diabetes duration, HbA1c, FBS, EF. also, no significant differences were observed in other echocardiographic measures including mild LVH, mild diastolic dysfunction, heart rate. Multivariate logistic regression identified LAVI as an independent predictor of CAD (OR = 1.24; 95% CI: 1.06–1.45), P = 0.006. ROC curve analysis showed that a LAVI cut-off of 28 mL/m² predicted CAD with 71% sensitivity and 51% specificity (P = 0.016).
CONCLUSION: LAVI could be a potentially useful, accessible and practical index for screening CAD in diabetic patients. It may be proposed as part of the workup for the diagnosis and management of CAD in type 2 diabetic patients.

Keywords

Left Atrial Volume Index
Coronary Artery Disease
Type 2 Diabetes
Echocardiography
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ARYA Atherosclerosis Journal
Volume 22, Issue 4
July and August 2026
Pages 21-29

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