The effects of type 1 diabetes mellitus on cardiac functions in children: evaluation by conventional and tissue Doppler echocardiography.
BACKGROUND
Several studies have pointed out the existence of cardiac dysfunction in patients with type 1 diabetes mellitus (DM) even in the absence of ischemic, valvular, or hypertensive heart disease. The present study evaluated cardiac dysfunction and the relationship between severity of disease and degree of cardiac dysfunction in children with type 1 DM.


METHODS
In this prospective study, 31 patients with type 1 DM and 33 sex- and age-matched healthy children were evaluated with conventional echocardiography and tissue Doppler echocardiography (TDE). A correlation between cardiac functions and glycated hemoglobin (HbA1C) was examined.


RESULTS
TDE results indicated that mitral valve early diastolic annular peak flow rate (E'), mitral valve systolic flow rate (S'), ratio of mitral valve early diastolic peak flow rate to mitral valve early diastolic annular peak flow rate (E/E'), and left ventricular (LV) myocardial performance index (MPI) were higher, and LV ejection time (ET) was shorter in patients with type 1 DM (p<0.05). In addition, tricuspid valve E' and right ventricular (RV) MPI were higher, while RV ET and tricuspid E/E' were lower in patients with type 1 DM compared to healthy children (p<0.05).


CONCLUSIONS
Although conventional echocardiography revealed no difference between patients with type 1 DM and healthy children, TDE showed dysfunctions of both ventricles. This state is closely related to degree of blood glucose level control. These findings signify diagnostic value of TDE in the early detection of cardiac effects among patients with type 1 DM.
Osman
O
Ozdemir
Adem Yasin
AY
Koksoy
Ayse Derya
AD
Bulus
Nesibe
N
Andiran
Elif
E
Yagli
D000293:Adolescent; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D011379:Prognosis; D011446:Prospective Studies; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*