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Left atrial dysfunction and stiffness in pediatric and adult patients with Type 1 diabetes mellitus assessed with speckle tracking echocardiography
Author(s) -
Ifuku Mayumi,
Takahashi Ken,
Hosono Yu,
Iso Takeshi,
Ishikawa Akimi,
Haruna Hidenori,
Takubo Noriyuki,
Komiya Kouji,
Kurita Mika,
Ikeda Fuki,
Watada Hirotaka,
Shimizu Toshiaki
Publication year - 2021
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.13141
Subject(s) - medicine , cardiology , ventricle , type 1 diabetes , subclinical infection , speckle tracking echocardiography , diabetic cardiomyopathy , cardiomyopathy , diabetes mellitus , diastole , heart failure , endocrinology , ejection fraction , blood pressure
Background Subclinical diastolic dysfunction in patients with Type 1 diabetes mellitus (T1DM) caused by myocardial injury due to diabetic cardiomyopathy leads to a high risk of death and heart failure. This myocardial injury extends not only to the left ventricle (LV) but also to the left atrium (LA). However, LA function in children and young adults with T1DM has not been extensively studied. Objective Therefore, the aim of this study was to assess LA dysfunction in pediatric and adult patients with T1DM using LA strain analysis with echocardiography. Subjects Fifty‐three patients (median age: 23 [range: 5–41] years) with T1DM. Methods We divided the patients into three age groups (D1: 5–14 years, D2: 15–24 years, D3: 25–41 years); 53 age‐ and sex‐matched controls were divided into three corresponding groups (C1, C2, and C3). LA and LV functions were evaluated using echocardiography. Results LA reservoir strain was lower in the D2 and D3 groups than in the C2 and C3 groups ( P = 0.001, P = 0.004, respectively). LA conduit strain was lower in the D2 group than in the C2 group ( P = 0.002). LA stiffness was significantly greater in the D3 group than in the C3 group ( P < 0.001). Conclusions In patients with T1DM, LA phasic function decreased in adolescents and young adults, and LA stiffness increased in adult patients aged >30 years. LA phasic function and LA stiffness can be potentially used as early markers for diastolic dysfunction.