Korean Circ J.  2010 Mar;40(3):125-130. 10.4070/kcj.2010.40.3.125.

Left Ventricular Function in Children and Adolescents With Type 1 Diabetes Mellitus

• Kim EH
• Kim YH

• KMID: 2094072
• DOI: http://doi.org/10.4070/kcj.2010.40.3.125

Abstract

BACKGROUND AND OBJECTIVES
Adult studies have reported that patients with diabetes mellitus (DM) show ultrastructural and functional myocardial deterioration. The aim of this study was to assess whether cardiac functional deterioration can be detected in pediatric patients with type I DM and whether or not a relatively short duration of DM and hyperglycemia influences cardiac function. SUBJECTS AND METHODS: Forty-seven children and adolescents with DM and 38 healthy subjects (control group) were enrolled. Glycosylated hemoglobin (HbA1c), DM-induced complications, and left ventricular (LV) function as assessed using conventional and unconventional echocardiography {tissue Doppler imaging (TDI) and vector velocity imaging (VVI)} were evaluated. RESULTS: The conventional echocardiographic parameters, with the exception of early peak mitral inflow velocity, the findings of pulsed wave TDI at the annular level, and regional ventricular function by VVI, were not significantly different between the two groups. Using the conventional and unconventional indices of systolic and diastolic function, no significant relationship was found between the duration of DM and the echocardiographic parameters. The deceleration time (DT) and E'/A' had an inverse correlation with HbA1c (p=0.042 and p=0.016, respectively). CONCLUSION: Patients with DM in childhood and early adolescence rarely have insight on the significance of DM, and their diet is difficult to control. An alteration of myocardial function induced by DM may begin earlier than generally thought, and these changes are accelerated when glycemic control is poor. We recommend the early institution of close observation of patients with diabetes for alterations in cardiac function, in addition to other diabetic complications.

Keyword

Child; Diabetes mellitus; Hyperglycemia; Ventricular function

MeSH Terms

Adolescent
Adult
Child
Deceleration
Diabetes Complications
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diet
Echocardiography
Hemoglobin A, Glycosylated
Humans
Hyperglycemia
Ventricular Function
Ventricular Function, Left
Hemoglobin A, Glycosylated

Figure

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  Fig. 1 Correlation between echocardiographic parameters and glycosylated hemoglobin (%). A: correlation between deceleration time (DT) and glycosylated hemoglobin (%). B: correlation between tissue Doppler imaging (TDI) E'/A' ratio and glycosylated hemoglobin (%).

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