title: Longitudinal left ventricular strain impairment in type 1 diabetes children and adolescents: a 2D speckle strain imaging study.
abstract: OBJECTIVE
  Type 1 diabetes (T1D) involves complex metabolic disturbances in cardiomyocytes leading to morphological and functional abnormalities of the myocardium. The relationship between T1D and cardiac structure and function in children is not well established. Our study investigated whether T1D is associated with early subclinical myocardial disturbances in children and adolescents, and whether the state of metabolic control and diabetes duration are influential factors.
  
  
  METHODS
  Standard echocardiography, tissue Doppler imaging (TDI) and two-dimensional (2D) strain imaging were prospectively performed in 100 T1D children (age: 11.3 ± 3.6 years, 52 boys) and compared with 79 controls.
  
  
  RESULTS
  The diabetic and control children were comparable with respect to age, gender, heart rate and blood pressure. There were no significant differences between the two groups in left ventricular (LV) ejection fraction, LV remodelling and TDI parameters. Conventional mitral Doppler demonstrated significantly fewer diastolic filling abnormalities with an early filling wave in the diabetes group. Global longitudinal strain (GLS) was also significantly lower in the T1D children, while circumferential strain and radial strain did not differ. GLS correlated with HbA1c (r=0.52; P<0.01), but there was no correlation with diabetes duration.
  
  
  CONCLUSIONS
  Our results suggest that LV longitudinal myocardial deformation is decreased in young patients with T1D, and glycaemic control may be the main risk factor for these changes. Further follow-up is now necessary to precisely determine the clinical significance of these myocardial changes detected by 2D strain imaging in T1D children.
authors.affiliation: CHU de Caen, Department of Cardiology, avenue Côte-de-Nacre, 14033 Caen, France. Electronic address: labombarda-f@chu-caen.fr.
authors.forename: F
authors.initials: F
authors.lastname: Labombarda
authors.affiliation: CHU de Caen, Department of Pediatrics, 14033 Caen, France. Electronic address: leport.mathilde@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Leport
authors.affiliation: CHU de Caen, Biostatistics and Clinical Research Unit, Université de Caen Basse-Normandie, Medical School, 14033 Caen, France. Electronic address: morello-r@chu-caen.fr.
authors.forename: R
authors.initials: R
authors.lastname: Morello
authors.affiliation: CHU de Caen, Department of Pediatrics, 14033 Caen, France. Electronic address: ribault-v@chu-caen.fr.
authors.forename: V
authors.initials: V
authors.lastname: Ribault
authors.affiliation: CHU de Caen, Department of Pediatrics, 14033 Caen, France. Electronic address: Kauffman-d@chu-caen.fr.
authors.forename: D
authors.initials: D
authors.lastname: Kauffman
authors.affiliation: CHU de Caen, Department of Pediatrics, 14033 Caen, France. Electronic address: brouard-j@chu-caen.fr.
authors.forename: J
authors.initials: J
authors.lastname: Brouard
authors.affiliation: CHU de Caen, Department of Cardiology, avenue Côte-de-Nacre, 14033 Caen, France. Electronic address: pellissier-a@chu-caen.fr.
authors.forename: A
authors.initials: A
authors.lastname: Pellissier
authors.affiliation: CHU de Caen, Department of Cardiology, avenue Côte-de-Nacre, 14033 Caen, France. Electronic address: maragnes-p@chu-caen.fr.
authors.forename: P
authors.initials: P
authors.lastname: Maragnes
authors.affiliation: EA 4650, Université de Caen Basse-Normandie, 14033 Caen, France; CHU de Caen, GIP CYCERON, Department of imaging, 14033 Caen, France. Electronic address: manrique-a@chu-caen.fr.
authors.forename: A
authors.initials: A
authors.lastname: Manrique
authors.affiliation: CHU de Caen, Department of Cardiology, avenue Côte-de-Nacre, 14033 Caen, France. Electronic address: milliez-p@chu-caen.fr.
authors.forename: P
authors.initials: P
authors.lastname: Milliez
authors.affiliation: CHU de Caen, Department of Cardiology, avenue Côte-de-Nacre, 14033 Caen, France. Electronic address: saloux-e@chu-caen.fr.
authors.forename: E
authors.initials: E
authors.lastname: Saloux
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: 2D strain; Children; Echocardiography; Type 1 diabetes