The HbA1C of the heart: Atrial volume index and outcomes of cardiac arrest

      In the care of the diabetic patient, the single best parameter to follow glycemic control over time is the level of glycosylated hemoglobin, or serum HbA1C. This one measurement more accurately reflects sugar control over longer time periods and is the single most important variable in assessing diabetes outcomes. In the heart, atria are not simply passive filling conduits, nor are they simply there to prime the ventricular pump before each systole. The atria act as compliance chambers, and can buffer the pulmonary vascular and systemic venous beds from acute changes in end-diastolic pressure. When filling pressures are high over time, not surprisingly, the chambers enlarge disproportionately. Atrial volumes (when normalized to body size), can thus be thought of as a long term marker for an array of physiologic insults that lead to high end-diastolic pressures – likening it to the echocardiographic equivalent of the HbA1c.
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