Evaluation of Cardiac Functions in Children and Adolescents with Type 1 Diabetes
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Background: Cardiac dysfunction in patients with type 1 diabetes (T1D) represents one of the serious complications. To evaluatethe cardiac function in children with T1D by conventional echocardiography and tissue Doppler imaging (TDI). Methods: The study included 40 T1D patients (age between 6 and 16 years) with > 5 years duration of diabetes and 42 healthycontrol children. The patients were subjected to clinical evaluation and laboratory investigations [glycosylated hemoglobin A1c(HbA1c), serum lipids and lipoproteins]. Conventional echocardiography and TDI were performed to patients and controls. Results: The patients had lower early diastolic filling velocity (E wave) of the tricuspid valve and mitral valves with a p valueof (0.000 and 0.006, respectively). TDI revealed that patients had lower S’velocity of the T1D, shorter isovolumic contractiontime, longer isovolumic relaxation time and lower E/E’ of the right ventricle than controls (p value 0.002, 0.001, 0.004, 0.003,and 0.016, respectively). The left ventricle (LV)-T1D of the patients was significantly higher (p value 0.02). Twenty eight patientshad poor glycemic control without significant differences between them and those with good glycemic control regarding echocardiographicdata. Patients with dyslipidemia (13 patients) had higher late diastolic filling velocity of the mitral valve (A) and thelower LV late tissue velocity (A’) (p wave 0.047 and 0.015). No correlation existed between the duration of illness or the level ofHbA1c and the echocardiographic parameters. Conclusion: Diabetic children have evidence of echocardiographic diastolic dysfunctions. Periodic cardiac evaluation withboth conventional and tissue Doppler echocardiography is recommended for early detection of this dysfunction.
Abstract
Background: Cardiac dysfunction in patients with type 1 diabetes (T1D) represents one of the serious complications. To evaluatethe cardiac function in children with T1D by conventional echocardiography and tissue Doppler imaging (TDI). Methods: The study included 40 T1D patients (age between 6 and 16 years) with > 5 years duration of diabetes and 42 healthycontrol children. The patients were subjected to clinical evaluation and laboratory investigations [glycosylated hemoglobin A1c(HbA1c), serum lipids and lipoproteins]. Conventional echocardiography and TDI were performed to patients and controls. Results: The patients had lower early diastolic filling velocity (E wave) of the tricuspid valve and mitral valves with a p valueof (0.000 and 0.006, respectively). TDI revealed that patients had lower S’velocity of the T1D, shorter isovolumic contractiontime, longer isovolumic relaxation time and lower E/E’ of the right ventricle than controls (p value 0.002, 0.001, 0.004, 0.003,and 0.016, respectively). The left ventricle (LV)-T1D of the patients was significantly higher (p value 0.02). Twenty eight patientshad poor glycemic control without significant differences between them and those with good glycemic control regarding echocardiographicdata. Patients with dyslipidemia (13 patients) had higher late diastolic filling velocity of the mitral valve (A) and thelower LV late tissue velocity (A’) (p wave 0.047 and 0.015). No correlation existed between the duration of illness or the level ofHbA1c and the echocardiographic parameters. Conclusion: Diabetic children have evidence of echocardiographic diastolic dysfunctions. Periodic cardiac evaluation withboth conventional and tissue Doppler echocardiography is recommended for early detection of this dysfunction.
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