Abstract
To assess right- and left-ventricular function in children with type 1 diabetes mellitus (DM) as well as correlate cardiac function with diabetes duration and state of metabolic control. The present study included 30 patients with type 1 DM (group 1) and 20 apparently normal children with comparable age and sex as controls (group 2). All children were subjected to detailed history, clinical examination, and routine laboratory investigations, including glycated hemoglobin, as well as conventional echocardiographic and tissue Doppler examination. Children with type 1 DM have impaired diastolic function in both left and right ventricles before the development of systolic dysfunction when assessed with either conventional or tissue Doppler echocardiography. Resting heart rate in diabetic patients showed a significant positive correlation with mitral A flow velocity and a significant negative correlation with mitral and tricuspid E/A ratio. Regarding morphological parameters of the left ventricle, all dimensions and volumes were comparable between diabetic patients and controls; however, a significant positive correlation was found between interventricular septal thickness at diastole (IVSd), interventricular septal thickness at systole (IVSs), and left ventricular posterior wall at systole (LVPWs) and the duration of diabetes. Children with type 1 DM have impaired diastolic function in both left and right ventricles with normal systolic function when assessed with either conventional or tissue Doppler echocardiography.
Similar content being viewed by others
References
Abdelrahman M, Negm H, Saleh A, Rozza A, Kholief H, Karawya S (2012) Tissue Doppler imaging in diabetic patients. Eur Heart J 14(Suppl A):20
Ahmed K, Inas A-S, El-Din HM (2005) Impact of type 1 diabetes mellitus on left-ventricular structure and function. J Am Cardiol 16(6):667–673
Alemzadeh R, Ali O (2012) Diabetes mellitus: type 1 diabetes mellitus (immune mediated). In: Kliegman RM, Stanton B, St. Geme J, Schor N, Behrman RE (eds) Nelson textbook of pediatrics, 19th edn. Elsevier, New York, pp 1968–1997
Asghar O, Al-Sunni A, Khavandi K, Ali K et al (2009) Diabetic cardiomyopathy. Clin Sci 116:741–760
Borzoee M, Kheirandish Z (2004) Doppler derived myocardial performance in healthy children in Shiraz. Iran J Med Sci 29(2):85–98
Cain P, Baglin T, Case C, Spicer D, Short L, Marwick TH (2001) Application of tissue Doppler to interpretation of dobutamine echocardiography and comparison with quantitative coronary angiography. Am J Cardiol 87:525–553
Centers for Disease Control (2011) Epidemiology of type 1 and type 2 diabetes mellitus among North American children and adolescents: SEARCH for Diabetes in Youth study
Cosson S, Kevorkian JP (2003) Left-ventricular diastolic dysfunction: an early sign of diabetic cardiomyopathy? Diabetes Metab 29(5):455–466
Cui W, Roberson DA, Chen Z, Madronero LF, Cuneo BF (2008) Systolic and Diastolic time intervals measured from Doppler tissue imaging: normal values and z-score, tables, and effects of age, heart rate, and body surface area. J Am Soc Echocardiogr 21(4):361–370
Eidem BW, McMahon CJ, Cohen RR, Wu J, Finkelshteyn I, Kovalchin JP et al (2004) Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 17:212–221
Elshahed GS, Ahmed MI, El-Beblawy NS, Kamal HF, Ismaiel MF, Bin Zheidan OAS (2008) Evaluation of right and LV systolic and diastolic function in patients with type I diabetes using echocardiography and tissue Doppler imaging. Suez Canal Univ Med J 11(1):65–74
Fang ZY, Prins JB, Marwick TH (2004) Diabetic cardiomyopathy: evidence, mechanisms and therapeutic implications. Endocr Rev 25:543–567
Fowler MJ (2008) Microvascular and macrovascular complications of diabetes. Clin Diabetes J 26(2):77–82
Freire CM, Moura AL, Barbosa MD, Machado LJ, Nogueira AI, Antônio JR (2007) Left Ventricle diastolic dysfunction in diabetes: an update. Arq Bras Endocrinol Metab 51(2):168–175
From AM, Scott CG, Chen HH (2009) Changes in diastolic dysfunction in diabetes mellitus over time. Am J Cardiol 103(10):1463–1466
Gul K, Celebi AS, Kacmaz F, Ozcan OC, Ustun I, Berker D et al (2009) Tissue Doppler imaging must be performed to detect early left-ventricular dysfunction in patients with type 1 diabetes mellitus. Eur J Echocardiogr 10:841–846
Karamitsos TD, Karvounis HI, Dalamanga EG, Papadopoulos CE, Didangellos TP, Karamitsos DT et al (2007) Early diastolic impairment of diabetic heart: the significance of right ventricle. Int J Cardiol 114:218–223
Kim EH, Kim YH (2010) Left-ventricular function in children and adolescents with type 1 diabetes mellitus. Korean Circ J 40:125–130
Kim H, Yoon H-J, Park H-S, Cho Y-K, Nam C-W, Hur S-H et al (2011) Usefulness of tissue Doppler imaging-myocardial performance index in the evaluation of diastolic dysfunction and heart failure with preserved ejection fraction. Clin Cardiol 34(8):494–499
Oyama MA, Weidman JA, Cole SG (2008) Calculation of pressure half-time. J Vet Cardiol 10(1):57–60
Paterson AD, Rutlegde BN, Cleary PA, Lachin JM, Crow RS et al (2007) The effect of intensive diabetes treatment on resting heart rate in type 1 diabetes: the diabetes control and complications trial: epidemiology of diabetes interventions and complications study. Diabetes Care 22(3):3–13
Patterson C (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–2020: a multicentre prospective registration study. Lancet 373:2027–2033
Schmitz L, Schneider MBE, Lange PE (2003) Isovolumic relaxation time corrected for heart rate has a constant value from infancy to adolescence. J Am Soc Echocardiogr 16:221–222
Schrödter D (2002) Diabetes mellitus—eine kardiovaskuläre Erkrankung, 1st edn. UNI-MED, Bremen
Spitaels S, Arbogast R, Fouron JC, Davignon A (1974) The influence of heart rate and age on the systolic and diastolic time intervals in children. Circulation 49:1107–1115
Tei C, Ks Dujardin, Do Hodge et al (1996) Doppler derived index combining systolic and diastolic myocardial performance: clinical value in cardiac amylodosis. J Am Coll Cardiol 28:658–664
Tei C, Nishimura RA, Seward JB, Tajik AJ (1997) Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 10:169–178
Vinik AI, Ziegler D (2007) Diabetic cardiovascular autonomic neuropathy. Circulation 115:387–397
Wilson BD, Litwin SE (2007) Tissue Doppler imaging: beautiful noise. Curr Cardiol Rev 3:81–90
Wong A, Wu J (2000) Small sample asymptomatic inference for the coefficient of variation: normal and nonnormal models. J Stat Plan Inference 104:73–82
Zile M, Brutsaert D (2002) New concepts in diastolic dysfunction and diastolic heart failure. I. Diagnosis, prognosis, and measurements of diastolic function. Circulation 105:1387–1393
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Khattab, A.A., Soliman, M.A. Biventricular Function and Glycemic Load in Type 1 Diabetic Children: Doppler Tissue-Imaging Study. Pediatr Cardiol 36, 423–431 (2015). https://doi.org/10.1007/s00246-014-1030-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-014-1030-3