title: Subclinical Left Ventricular Longitudinal and Radial Systolic Dysfunction in Children and Adolescents with Type 1 Diabetes Mellitus.
abstract: BACKGROUND
  There are few studies of subclinical systolic dysfunctions in children and adolescents with type 1 diabetes mellitus (DM), and so the available data are limited. The aim of this study was to determine early echocardiographic signs of LV systolic dysfunction in children and adolescents with type 1 DM using two-dimensional speckle tracking echocardiography (2DSTE).
  
  
  METHODS
  The study included 84 children and adolescents with type 1 DM and 32 sex-, age-, and body mass index-matched healthy subjects. The LV functions were assessed using conventional echocardiography, tissue Doppler imaging, and 2DSTE.
  
  
  RESULTS
  The results showed LV diastolic dysfunction as reflected by significantly increased A-wave velocity, decreased E/A ratio, and increased early filling deceleration time in the patients with diabetes (P = 0.02, P = 0.029, and P = 0.04; respectively). Compared with the control group, patients with diabetes showed significantly lower values for longitudinal systolic strain and strain rate in most segments of the LV; for radial strain values of the LV; for lateral circumferential strain and posterior and anterolateral circumferential strain rate of the LV; and for global longitudinal and radial strain of the LV. Global longitudinal and radial strain values of the LV were significantly lower among patients with poor glycemic control than in the control group.
  
  
  CONCLUSIONS
  In addition to diastolic dysfunction, LV longitudinal and radial function was found to be impaired in asymptomatic children and adolescents with type 1 DM who have normal LV ejection fraction by 2DSTE. Glycemic control may be the main risk factor for alteration of myocardial function.
authors.affiliation: Department of Pediatric Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Gürkan
authors.initials: G
authors.lastname: Altun
authors.affiliation: Department of Pediatric Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Babaoğlu
authors.affiliation: Department of Pediatric Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Köksal
authors.initials: K
authors.lastname: Binnetoğlu
authors.affiliation: Department of Pediatric Endocrinology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Özsu
authors.affiliation: Department of Pediatric Endocrinology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Rahime G
authors.initials: RG
authors.lastname: Yeşiltepe Mutlu
authors.affiliation: Department of Pediatric Endocrinology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Hatun
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D042241:Early Diagnosis; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014421:Turkey / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: diabetes mellitus; doppler echocardiography; strain; systolic function