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Left ventricular functions in pediatric patients with ten years or more type 1 diabetes mellitus: Conventional echocardiography, tissue Doppler, and two‐dimensional speckle tracking study
Author(s) -
Rakha Shaimaa,
Aboelenin Hadil M.
Publication year - 2019
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12900
Subject(s) - medicine , cardiology , microalbuminuria , type 1 diabetes , ventricle , glycated hemoglobin , diabetes mellitus , population , speckle tracking echocardiography , diabetic cardiomyopathy , ejection fraction , type 2 diabetes , heart failure , cardiomyopathy , blood pressure , endocrinology , environmental health
Background Cardiac dysfunction is a complication of type 1 diabetes mellitus (T1DM) with primary concern in adults. However, studies have evaluated left ventricle (LV) myocardial changes in pediatrics but not the long‐term effect of T1DM in such vulnerable age. Therefore, we assessed LV functions in pediatric patients with long‐duration T1DM using different echocardiographic modalities. Methods Between July 2015 and March 2016, 48 T1DM patients were prospectively compared to 35 healthy controls. Pediatric patients with T1DM for 10 years or more were included in the study. Patients were subjected to history taking, clinical examination, glycated hemoglobin (HbA1c), and microalbuminuria measurements. Moreover, conventional echocardiography, tissue Doppler, and 2D speckle tracking were performed to analyze LV functions. Results Mean age of patients was 15.5 ± 2 years, and mean T1DM duration was 11.7 ± 1.8 years. LV dimensions, EF and FS, and mass index did not statistically differ between groups, but E / E ′ ratio was significantly higher in the diabetic group. Global longitudinal strain (GLS) and global circumferential strain (GCS) were significantly lower in diabetic patients compared with controls ( P = 0.038; P = 0.001, respectively). Mean HbA1c was found to be a significant predictor of decreased GLS in the diabetic population (95% CI, 0.096‐0.244; P = 0.001) but not predicting GCS. Microalbuminuria had no significance in predicting strain. Conclusions Despite the long‐duration of affection with T1DM during childhood in our patients, alterations on LV myocardial function could not be detected either clinically or by conventional echocardiography. Tissue Doppler and speckle tracking could be used in the follow up of myocardial status in pediatric diabetic patients.