J Cardiovasc Ultrasound.  2017 Mar;25(1):12-19. 10.4250/jcu.2017.25.1.12.

Evaluation of Cardiac Functions in Children and Adolescents with Type 1 Diabetes

• M Abd-El Aziz F
• Abdelghaffar S
• M Hussien
• M Fattouh

• KMID: 2375292
• DOI: http://doi.org/10.4250/jcu.2017.25.1.12

Abstract

BACKGROUND
Cardiac dysfunction in patients with type 1 diabetes (T1D) represents one of the serious complications. To evaluate the cardiac function in children with T1D by conventional echocardiography and tissue Doppler imaging (TDI).
METHODS
The study included 40 T1D patients (age between 6 and 16 years) with > 5 years duration of diabetes and 42 healthy control children. The patients were subjected to clinical evaluation and laboratory investigations [glycosylated hemoglobin A1c (HbA1c), serum lipids and lipoproteins]. Conventional echocardiography and TDI were performed to patients and controls.
RESULTS
The patients had lower early diastolic filling velocity (E wave) of the tricuspid valve and mitral valves with a p value of (0.000 and 0.006, respectively). TDI revealed that patients had lower S"²velocity of the T1D, shorter isovolumic contraction time, longer isovolumic relaxation time and lower E/E"² of the right ventricle than controls (p value 0.002, 0.001, 0.004, 0.003, and 0.016, respectively). The left ventricle (LV)-T1D of the patients was significantly higher (p value 0.02). Twenty eight patients had poor glycemic control without significant differences between them and those with good glycemic control regarding echocardiographic data. Patients with dyslipidemia (13 patients) had higher late diastolic filling velocity of the mitral valve (A) and the lower LV late tissue velocity (A"²) (p wave 0.047 and 0.015). No correlation existed between the duration of illness or the level of HbA1c and the echocardiographic parameters.
CONCLUSION
Diabetic children have evidence of echocardiographic diastolic dysfunctions. Periodic cardiac evaluation with both conventional and tissue Doppler echocardiography is recommended for early detection of this dysfunction.

Keyword

Tissue Doppler echocardiography; Type 1 diabetes; Children; Diabetic cardiomyopathy

MeSH Terms

Adolescent*
Child*
Diabetic Cardiomyopathies
Dyslipidemias
Echocardiography
Echocardiography, Doppler
Heart Ventricles
Humans
Mitral Valve
Relaxation
Tricuspid Valve

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