Cardiac functions assessment in children with celiac disease and its correlation with the degree of mucosal injury: Doppler tissue imaging study

Abstract

Background/Aims:Celiac disease (CD)-associated cardiologic disorders is a growing concern. However, data regarding cardiac affection in children with CD are few. This study aimed at assessing the subclinical impact of CD on the global myocardial performance in Saudi children with CD using Doppler tissue imaging (DTI).Patients and Methods:Conventional two-dimensional echocardiography was performed among 20 Saudi children with CDas well as 20 age and sex-matched healthy controls. DTI were used to determine right ventricular (RV) and left ventricular (LV) Tei indexes. These findings were correlated with the Modified Marsh Classification of the histologic findings in CD.Results:LV and RV Tei indexes were significantly higher in children with CD than the control group (mean ± standard deviation: 0.47 ± 0.05 vs. 0.31 ± 0.18; P < 0.0005 and 0.51 ± 0.04 vs. 0.32 ± 0.05; P < 0.0001, respectively). RV Tei index was found to be positively correlated with the Modified Marsh Classification of CD (r = 0.7753, P < 0.0001). LV Tei index tended to be more affected in patients with more severe histologic findings, however, such relation did not reach statistical significance (r = 0.2479, P = 0.292). Fractional shortening did not correlate with the Modified Marsh Classification of histologic findings in CD patients (r= −0.11, P = 0.641).Conclusions:Subclinical myocardial dysfunction of both ventricles occurs in children with CD. The DTI method appears to be more sensitive than conventional two-dimensional echocardiography in the early detection of myocardial dysfunction in children with CD.

Subklinik Çölyak hastalığı olan çocuklarda erken ateroskleroz riskinin aortik elasitisite parametreleri ile belirlenmesi

“…In our study, there was no significant cardiac dysfunction between patients and controls according to conventional echocardiography in accordance with the literature 8,19 . However, when evaluated by TDI echocardiography, it was shown that both the left ventricle and the right ventricle had systolic and diastolic dysfunction in the patient group.…”

“…Because of this data, recent investigations have focused on noninvasive echocardiography methods that can detect subclinical myocarditis. In a small number of studies in children with CD, early cardiac involvement has been shown to be detectable by TDI echocardiography 8,19 .…”

Left ventricular mechanics are affected in children with celiac disease: A study based on two‐dimensional speckle tracking echocardiography

“…Due to obtained data regarding cardiac involvement in patients with CD, recent studies focused on noninvasive echocardiographic methods which can detect subclinical carditis before development of potential dilated cardiomyopathy . A few studies have indicated that early cardiac involvement in patients with CD can be detected by TDI echocardiography in both adults and children . In our study, none of the patients with CD had LV systolic and diastolic dysfunctions according to conventional echocardiography.…”

“…15 A few studies have indicated that early cardiac involvement in patients with CD can be detected by TDI echocardiography in both adults 16,17 and children. [18][19][20] In our study, none of the patients with CD had LV systolic and diastolic dysfunctions according to conventional echocardiography. Despite the similarities in previous studies and our study, in terms of the size of the study population, the duration of CD and the age of patients, we did not detect any difference between patient and control groups by TDI echocardiography.…”

Cardiovascular involvement in celiac disease

“…Patients with CD can have impaired diastolic and systolic function as measured by tissue Doppler echocardiography[ 141 ]. Mitral valve prolapse[ 142 ] and subclinical myocardial dysfunction of both ventricles[ 143 ] can be present in both the pediatric and adult CD population. In children, significantly lower contractility indices and higher left ventricular dimensions are evident as compared with controls[ 144 ].…”