Evaluation of electrocardiographic parameters for early diagnosis of autonomic dysfunction in children and adolescents with type‐1 diabetes mellitus

Uysal, Fahrettin; Özboyacı, Evren; Bostan, Özlem; Sağlam, Hilal; Semizel, Evren; Çil, Ergün

doi:10.1111/ped.12329

Cited by 17 publications

(19 citation statements)

References 23 publications

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“…7,41,42 In the present study, we found a positive correlation between therapeutic response and QTcd value, thus supporting this possible mechanism for physical treatment.…”

Section: Discussionsupporting

confidence: 79%

Electrocardiography-Derived Predictors for Therapeutic Response to Treatment in Children with Postural Tachycardia Syndrome

Yan

et al. 2016

The Journal of Pediatrics

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“…7,41,42 In the present study, we found a positive correlation between therapeutic response and QTcd value, thus supporting this possible mechanism for physical treatment.…”

Section: Discussionsupporting

confidence: 79%

Electrocardiography-Derived Predictors for Therapeutic Response to Treatment in Children with Postural Tachycardia Syndrome

Yan

et al. 2016

The Journal of Pediatrics

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“…Further investigations are necessary to elucidate this finding and its relevance in DCM. In children with T1DM, P wave dispersion was higher compared to controls [44].…”

Section: Plos Onementioning

confidence: 69%

Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats

et al. 2020

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Diabetes can elicit direct deleterious effects on the myocardium, independent of coronary artery disease or hypertension. These cardiac disturbances are termed diabetic cardiomyopathy showing increased risk of heart failure with or without reduced ejection fraction. Presently, there is no specific treatment for this type of cardiomyopathy and in the case of type I diabetes, it may start in early childhood independent of glycemic control. We hypothesized that alterations in isolated myocyte contractility and cardiac function are present in the early stages of experimental diabetes in rats before overt changes in myocardium structure occur. Diabetes was induced by single-dose injection of streptozotocin (STZ) in rats with data collected from control and diabetic animals 3 weeks after injection. Left ventricle myocyte contractility was measured by single-cell length variation under electrical stimulation. Cardiac function and morphology were studied by high-resolution echocardiography with pulsed-wave tissue Doppler imaging (TDI) measurements and three-lead surface electrocardiogram. Triglycerides, cholesterol and liver enzyme levels were measured from plasma samples obtained from both groups. Myocardial collagen content and perivascular fibrosis of atria and ventricle were studied by histological analysis after picrosirius red staining. Diabetes resulted in altered contractility of isolated cardiac myocytes with increased contraction and relaxation time intervals. Echocardiography showed left atrium dilation, increased enddiastolic LV and posterior wall thickness, with reduced longitudinal systolic peak velocity (S') of the septum mitral annulus at the apical four-chamber view obtained by TDI. Triglycerides, aspartate aminotransferase and alkaline phosphatase were elevated in diabetic animals. Intertitial collagen content was higher in atria of both groups and did not differ among control and diabetic animals. Perivascular intramyocardial arterioles collagen did not differ between groups. These results suggest that alterations in cardiac function are present in the early phase in this model of diabetes type 1 and occur before overt changes in myocardium structure appear as evaluated by intersticial collagen deposition and perivascular fibrosis of intramyocardial arterioles.

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“…Cardiac autonomic neuropathy (CAN) consists of sympathetic and parasympathetic dysfunction and it is known to lead to sudden death in adults. QTc interval has been used to demonstrate CAN in adults rather than prolonged ventricular depolarization and repolarization (12). Marthur et al (13) conducted a study with 50 asymptomatic adult patients with diabetes in 2006 and found findings of CAN in 19 patients; QTc prolongation was found in 15 of these patients.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic changes in children with diabetic ketoacidosis and ketosis

et al. 2018

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Aim: We aimed to study electrocardiographic changes in children with diabetic ketoacidosis and ketosis and to evaluate the relation of the changes with serum electrolyte levels and ketosis. Results: Forty patients were included in the study; 16 (40%) were diagnosed as having diabetic ketosis and 24 (60%) had diabetic ketoacidosis. Twenty-four (60%) patients were male and 16 (40%) were female and the mean age was 9.21±4.71 years (range, 1-16 years). Twelve (30%) cases of diabetic ketoacidosis were mild, three (7.5%) were moderate, and nine (22.5%) were severe. One patient had premature ventricular beats, and four had ST depression. The electrocardiographic parameters were all normal beyond the QTC length prolongation. The mean QTC length was 447±45 ms (380-560 ms) at diagnosis and 418±32 ms (350-500 ms) after treatment. The change in the QTC length was statistically significant. None of the patients had significant electrolyte disturbance and the prolongation of QTc length was not correlated with serum electrolyte levels. The prolongation of QTc length was statistically correlated with anion gap (r=0.33, p=0.03). Conclusions:In our study, we showed QTc length prolongation and the importance of performing electrocardiography during the diagnosis of diabetic ketoacidosis and ketosis. We also demonstrated that ketosis was responsible for the prolongation of QTc length.

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Evaluation of electrocardiographic parameters for early diagnosis of autonomic dysfunction in children and adolescents with type‐1 diabetes mellitus

Abstract: Cardiac autonomic function disorder, which is one of the most important causes of morbidity and mortality, may emerge in the course of type 1 diabetes mellitus. It can be diagnosed on ECG even when the patients are asymptomatic.

Cited by 17 publications

References 23 publications

Electrocardiography-Derived Predictors for Therapeutic Response to Treatment in Children with Postural Tachycardia Syndrome

Electrocardiography-Derived Predictors for Therapeutic Response to Treatment in Children with Postural Tachycardia Syndrome

Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats

Electrocardiographic changes in children with diabetic ketoacidosis and ketosis

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