title: Cardiac functions assessment in children with celiac disease and its correlation with the degree of mucosal injury: Doppler tissue imaging study.
abstract: OBJECTIVE
  Celiac disease (CD)-associated cardiologic disorders is a growing concern. However, data regarding cardiac affection in children with CD are few. This study aimed at assessing the subclinical impact of CD on the global myocardial performance in Saudi children with CD using Doppler tissue imaging (DTI).
  
  
  METHODS
  Conventional two-dimensional echocardiography was performed among 20 Saudi children with CDas well as 20 age and sex-matched healthy controls. DTI were used to determine right ventricular (RV) and left ventricular (LV) Tei indexes. These findings were correlated with the Modified Marsh Classification of the histologic findings in CD.
  
  
  RESULTS
  LV and RV Tei indexes were significantly higher in children with CD than the control group (mean ± standard deviation: 0.47 ± 0.05 vs. 0.31 ± 0.18; P< 0.0005 and 0.51 ± 0.04 vs. 0.32 ± 0.05; P< 0.0001, respectively). RV Tei index was found to be positively correlated with the Modified Marsh Classification of CD (r = 0.7753, P< 0.0001). LV Tei index tended to be more affected in patients with more severe histologic findings, however, such relation did not reach statistical significance (r = 0.2479, P = 0.292). Fractional shortening did not correlate with the Modified Marsh Classification of histologic findings in CD patients (r= -0.11, P = 0.641).
  
  
  CONCLUSIONS
  Subclinical myocardial dysfunction of both ventricles occurs in children with CD. The DTI method appears to be more sensitive than conventional two-dimensional echocardiography in the early detection of myocardial dysfunction in children with CD.
authors.affiliation: Department of Pediatrics, College of Medicine, Taibah University, Madinah, Saudi Arabia.
authors.forename: Abeer
authors.initials: A
authors.lastname: Fathy
authors.affiliation: Department of Pediatrics, College of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Hany M
authors.initials: HM
authors.lastname: Abo-Haded
authors.affiliation: Department of Pediatrics, Maternity and Children Hospital, Madinah, Saudi Arabia.
authors.forename: Najat
authors.initials: N
authors.lastname: Al-Ahmadi
authors.affiliation: Department of Child Health, Medical Research Division, National Research Centre, Cairo, Egypt.
authors.forename: Marwa M
authors.initials: MM
authors.lastname: El-Sonbaty
mesh_terms: D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000503:physiopathology; D002648:Child; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012529:Saudi Arabia / Q000453:epidemiology