title: Decreased regional left ventricular myocardial strain in type 1 diabetic children: a first sign of diabetic cardiomyopathy?
abstract: OBJECTIVE
  Type 1 diabetes is a major cardiovascular risk factor associated with an excess of mortality in young adults due to premature cardiovascular events, which includes heart failure. The relation between type 1 diabetes and cardiac structure and function in children was poorly documented. Our study investigates (1) whether type 1 diabetic children have echocardiographic signs of subclinical cardiac dysfunction assessed by tissue Doppler strain and (2) whether state of metabolic control and diabetes duration have any influence on the cardiac event.
  
  
  METHODS
  Standard echocardiography and tissue Doppler imaging were prospectively performed in type 1 diabetic children. Left ventricular dimensions, standard indices of systolic and diastolic function, and septal longitudinal strain were investigated.
  
  
  RESULTS
  Thirty consecutive asymptomatic diabetic children (age: 12.4 [5-17] years; males: 53%) were compared to 30 age and sex-matched healthy control subjects. Left ventricular mass index and diastolic septal thickness were significantly increased in diabetic children. There was no difference between two groups as regards the left ventricular ejection fraction and conventional mitral Doppler parameters (E, A, Ea). The global longitudinal systolic strain and strain rate were found to be decreased in children with diabetes. The global longitudinal early diastolic strain rate (Esr) was negatively correlated with metabolic control. Longitudinal strain was not correlated with diabetes duration.
  
  
  CONCLUSIONS
  Children with Type 1 diabetes had subclinical alterations in left ventricular size and longitudinal myocardial deformation.
authors.affiliation: Department of Cardiology, Caen CHU, Caen, F-14000, France.
authors.forename: Amir
authors.initials: A
authors.lastname: Hodzic
authors.affiliation: Department of Pediatrics, Caen CHU, Caen, F-14000, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Ribault
authors.affiliation: Department of Cardiology, Caen CHU, Caen, F-14000, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Maragnes
authors.affiliation: Department of Cardiology, Caen CHU, Caen, F-14000, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Milliez
authors.affiliation: Department of Cardiology, Caen CHU, Caen, F-14000, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Saloux
authors.forename: Fabien
authors.initials: F
authors.lastname: Labombarda
keywords: childrend; left ventricular size; longitudinal myocardial deformation; type 1 diabetes