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

Abstract

Background and ObjectivesAdult 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 MethodsForty-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.ResultsThe 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).ConclusionPatients 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.

Subclinical Left Ventricular Dysfunction in Asymptomatic Type 1 Diabetic Children

“…However, in our results, we could find no correlation between HbA1C and decreased GLS. These findings don't agree with studies demonstrating a relationship between glycemic control and cardiac function in diabetic children [14]. They found that a higher mean HbA1c was significantly associated with changes in LV structure and function in patients with T1D.…”

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

“…Studies on adults have reported that patients with T1D show ultra-structural and functional myocardial deterioration 3). Similarly, it has been reported that young patients with T1D have significant changes in left ventricular dimension and myocardial relaxation 4).…”

Asymmetric dimethylarginine levels and diabetes duration: Relationship with measures of subclinical atherosclerosis and cardiac function in children and adolescents with Type 1 diabetes

“…However, we calculated mean HbA1c levels in patients, whereas in other studies, only the level of HbA1c at the time of study was considered. 18,30,34 To date, there is only one other study showing the relationship between ADMA levels and echocardiographic parameters in childhood T1DM. Abd El Dayem et al 20 not only found a negative relationship between NO levels and echocardiographic parameters but also showed that the most important indicator of NO levels is ADMA concentration.…”