Can ambulatory blood pressure monitoring detect early diastolic dysfunction in children with type 1 diabetes mellitus: correlations with B-type natriuretic peptide and tissue Doppler findings

Kır, Mustafa; Çetin, Benhur Şirvan; Demır, Kadir; Yılmaz, Nuh; Kızılca, Özgür; Demircan, Tülay; Ünal, Nurettin; Böber, Ece; Saylam, Gül Sağın

doi:10.1111/pedi.12234

Cited by 11 publications

(5 citation statements)

References 29 publications

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“…Chronic hyperglycaemia in DM damages the heart and causes myocardial dysfunction. 18,30,31 In this study, we found a significant increase in LVpWT and IVST on conventional echocardiography after 5 years of diabetes duration. In previous studies, no change in IVST was detected in children and adolescents with T1DM when compared to healthy controls.…”

Section: Discussionsupporting

confidence: 56%

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

Ersoy

Eroğlu

Çetin

et al. 2018

Diabetes and Vascular Disease Research

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Aims: We aimed to evaluate asymmetric dimethylarginine levels in young patients with Type 1 diabetes mellitus according to diabetes duration and to examine the relationship between these levels and measures of atherosclerosis and myocardial function. Materials and methods: In total, 83 patients (8.5-22 years) with Type 1 diabetes mellitus were stratified by diabetes duration: 12-60 months (Group 1, n = 27), >60-120 months (Group 2, n = 29) and >120 months (Group 3, n = 27). Asymmetric dimethylarginine levels were assessed. Carotid intima-media thickness was measured. Myocardial function was assessed by M-mode, conventional Doppler and tissue Doppler echocardiography. Results: Asymmetric dimethylarginine level was significantly higher in Group 1, while carotid intima-media thickness was significantly greater in Group 3 (p < 0.05). Tissue Doppler echocardiography showed the ratio of peak early to peak late diastolic myocardial annular velocity decreased significantly in Groups 2 and 3 with a negative correlation with duration (r: −0.310, p = 0.004) and HBA1c levels (r = −0.391, p < 0.001). Myocardial performance index in all groups and isovolumic relaxation time in Group 3 increased significantly. Asymmetric dimethylarginine levels were negatively correlated with carotid intima-media thickness and isovolumic relaxation time (p < 0.05). Conclusion: In contrast to adult diabetics, asymmetric dimethylarginine concentration decreases as diabetes duration increases in young Type 1 diabetic patients and is associated with worsening measures of cardiovascular risk and poorer diastolic function.

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Section: Discussionsupporting

confidence: 56%

“…However, it was reported that the E/A ratio was lower in T1DM children than in healthy controls. 18,30,31 We found that IVRT was prolonged, and MPI was impaired in long-term diabetes. While IVRT showed significant differences between all groups, MPI showed a significant impairment only after the fifth year.…”

Section: Discussionmentioning

confidence: 88%

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

Ersoy

Eroğlu

Çetin

et al. 2018

Diabetes and Vascular Disease Research

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“…Data on natriuretic peptides' importance and prognostic performance in type 1 diabetes are sparse (6,32,33,34). However, their release from cardiomyocytes in response to stress and their close relationship to both diagnosis and prognosis of heart failure makes them an apparent marker of myocardial function to investigate.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular prognostic value of echocardiography and N terminal pro B-type natriuretic peptide in type 1 diabetes: the Thousand & 1 Study

Rørth

Jørgensen

Andersen

et al. 2020

European Journal of Endocrinology

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Aims Patients with type 1 diabetes have a high risk of cardiovascular disease. Yet, the importance of routine assessment of myocardial function in patients with type 1 diabetes is not known. Thus, we examined the prognostic importance of NT-proBNP and E/e′, an echocardiographic measure of diastolic function, in type 1 diabetes patients with preserved left ventricular ejection fraction (LVEF) and without known heart disease. Methods and results Type 1 diabetes patients without known heart disease and LVEF ≥45% enrolled in the Thousand and 1 study were included and followed through nationwide registries. The risk of major cardiovascular events (MACE) and death associated with levels of NT-proBNP and E/e′ was examined. Of 960 patients, median follow-up of 6.3 years (Q1–Q3: 5.7–7.0), 121 (12%) experienced MACE and 51 (5%) died. Increased levels of both NT-proBNP and E/e′ were associated with worse outcomes (adjusted hazard ratios for MACE = 1.56 (1.23–1.98) and 4.29 (2.25–8.16) per Loge increase for NT-proBNP and E/e′, respectively). NT-proBNP and E/e′ combined significantly improved the discrimination power of the Steno T1D risk engine (MACE, C-index: 0.813 (0.779–0.847) vs 0.779 (0.742–0.816); P = 0.0001; All-cause mortality, C-index 0.855 (0.806–0.903) vs 0.828 (0.776–0.880); P = 0.03). Conclusion In patients with type 1 diabetes, preserved ejection fraction, and no known heart disease, NT-proBNP and E/e′ were associated with increased risk of MACE and all-cause mortality. The risks associated with NT-proBNP and E/e′ combined identified patients at remarkably high risk.

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“…Cardiac functional abnormalities are associated with BMI in children and adolescents with and without diabetes, suggesting that the control of obesity is mandatory to prevent cardiac disease, especially in those with diabetes in which the progression of cardiac abnormalities seems accelerated [ 82 , 84 , 85 ]. In children with T1D, cardiac dysfunction seems to be influenced by disease duration, poor glycemic control, microalbuminuria, retinopathy and increased blood pressure [ 83 , 86 , 87 ]. Left ventricular performance has also been studied during physical activity sessions in adolescents with and without diabetes and, as expected, those with T1D or T2D showed a lower exercise tolerance compared to healthy controls [ 88 , 89 ].…”

Section: Cardiac Dysfunction In Children and Adolescents With Diabmentioning

confidence: 99%

The Impact of Diabetes Mellitus on Cardiovascular Risk Onset in Children and Adolescents

Pastore

Bolla

Montefusco

et al. 2020

IJMS

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The prevalence of diabetes mellitus is rising among children and adolescents worldwide. Cardiovascular diseases are the main cause of morbidity and mortality in diabetic patients. We review the impact of diabetes on establishing, during childhood and adolescence, the premises for cardiovascular diseases later in life. Interestingly, it seems that hyperglycemia is not the only factor that establishes an increased cardiovascular risk in adolescence. Other factors have been recognized to play a role in triggering the onset of latent cardiovascular diseases in the pediatric population. Among these cardiovascular risk factors, some are modifiable: glucose variability, hypoglycemia, obesity, insulin resistance, waist circumference, hypertension, dyslipidemia, smoking alcohol, microalbuminuria and smoking. Others are unmodifiable, such as diabetes duration and family history. Among the etiological factors, subclinical endothelial dysfunction represents one of the earliest key players of atherosclerosis and it can be detected during early ages in patients with diabetes. A better assessment of cardiovascular risk in pediatric population still represents a challenge for clinicians, and thus further efforts are required to properly identify and treat pediatric patients who may suffer from cardiovascular disease later in early adulthood.

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Can ambulatory blood pressure monitoring detect early diastolic dysfunction in children with type 1 diabetes mellitus: correlations with B-type natriuretic peptide and tissue Doppler findings

Abstract: Elevated BP loads detected by 24-h ambulatory BP measurements in children with type 1 diabetes are associated with increased BNP levels and abnormal tissue Doppler echocardiography indices, indicating early stage cardiac dysfunction.

Cited by 11 publications

References 29 publications

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

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

Cardiovascular prognostic value of echocardiography and N terminal pro B-type natriuretic peptide in type 1 diabetes: the Thousand & 1 Study

The Impact of Diabetes Mellitus on Cardiovascular Risk Onset in Children and Adolescents

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