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.

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Background: This study aimed to assess the role of copeptin as a diagnostic marker of heart failure (HF) and outcomes. Method: We randomly recruited 76 cardiac patients aged 1 month to 15 years and 65 control healthy children matched in age and sex. Based on plasma copeptin level, the study population were sub-grouped into quartiles (Q). Results: The mean age of cases and control was 40.52 ±34.35 months and 42.43 ±30.42 months respectively. Median copeptin level was higher among patients 16.80 (16.4) compared to control 8.00 (3.0), P<0.01. Copeptin level was not statistically significantly different in-between patients with different etiologies of HF, P =0.515. Total leukocytic count, platelets, serum sodium, inotropic score, and troponin were significantly correlated with copeptin quartile. Three-fourth of dead children were within the Q4, and 12.5 % were within the first one, P=0.214. Around 76.5% of patients who had multiorgan dysfunction were within the Q4 while 5.9% belonged to Q1, P=0.022. Of those who developed sepsis, 82.6% and 4.3% were located within Q4 and Q1, P<0.01. All patients who required mechanical ventilation were within Q4, P= 0.005. Conclusion: Plasma level of copeptin is elevated in pediatric HF regardless its etiology and can be used as a predictor of poor outcomes.

Nonobstructive coronary artery lesions of diabetic patients have distinct compositional and morphological features, suggesting that these differences may explain the increased likelihood of coronary events in diabetic patients.

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