Investigation of endothelial dysfunction and arterial stiffness in children with type 1 diabetes mellitus and the association with diastolic dysfunction

Çiftel, Murat; Ertuğ, Halil; Parlak, Mesut; Akçurin, Gayaz; Kardelen, Fırat

doi:10.1177/1479164113508564

Cited by 45 publications

(39 citation statements)

References 31 publications

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“…These changes reflect early changes in myocardial relaxation. DD in diabetic children was reported by other investigators 21)22)23). LV DD in patients with diabets mellitus (DM) may be caused by increased LV diastolic stiffness, deposition of advanced glycation end (AGE) products, and cardiac fibrosis, all as a consequence of DM 3).…”

Section: Discussionmentioning

confidence: 82%

Evaluation of Cardiac Functions in Children and Adolescents with Type 1 Diabetes

Aziz

Abdelghaffar

Hussien

et al. 2017

J Cardiovasc Ultrasound

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BackgroundCardiac dysfunction in patients with type 1 diabetes (T1D) represents one of the serious complications. To evaluate the cardiac function in children with T1D by conventional echocardiography and tissue Doppler imaging (TDI).MethodsThe study included 40 T1D patients (age between 6 and 16 years) with > 5 years duration of diabetes and 42 healthy control children. The patients were subjected to clinical evaluation and laboratory investigations [glycosylated hemoglobin A1c (HbA1c), serum lipids and lipoproteins]. Conventional echocardiography and TDI were performed to patients and controls.ResultsThe patients had lower early diastolic filling velocity (E wave) of the tricuspid valve and mitral valves with a p value of (0.000 and 0.006, respectively). TDI revealed that patients had lower S′velocity of the T1D, shorter isovolumic contraction time, longer isovolumic relaxation time and lower E/E′ of the right ventricle than controls (p value 0.002, 0.001, 0.004, 0.003, and 0.016, respectively). The left ventricle (LV)-T1D of the patients was significantly higher (p value 0.02). Twenty eight patients had poor glycemic control without significant differences between them and those with good glycemic control regarding echocardiographic data. Patients with dyslipidemia (13 patients) had higher late diastolic filling velocity of the mitral valve (A) and the lower LV late tissue velocity (A′) (p wave 0.047 and 0.015). No correlation existed between the duration of illness or the level of HbA1c and the echocardiographic parameters.ConclusionDiabetic children have evidence of echocardiographic diastolic dysfunctions. Periodic cardiac evaluation with both conventional and tissue Doppler echocardiography is recommended for early detection of this dysfunction.

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Section: Discussionmentioning

confidence: 82%

Evaluation of Cardiac Functions in Children and Adolescents with Type 1 Diabetes

Aziz

Abdelghaffar

Hussien

et al. 2017

J Cardiovasc Ultrasound

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“…Dysfunction of the vascular endothelium is regarded as an important factor in the pathogenesis of vascular complications in patients with DM. 15 Chronic low-grade inflammation can be the cause and the consequence of endothelial dysfunction. 16 In addition, enhanced activation of the clotting cascade has recently been implicated as an important contributing factor for the occurrence of vascular complications in DM.…”

Section: Discussionmentioning

confidence: 99%

Associations Between Inflammatory Markers, Hemostatic Markers, and Microvascular Complications in 182 Chinese Patients With Type 2 Diabetes Mellitus

Zheng

Shi

Chen

et al. 2015

Lab Med

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Objective: To examine the associations between inflammatory markers, coagulation and fibrinolysis parameters, and microvascular complications in 182 Chinese patients with type 2 diabetes mellitus (T2DM) who sought treatment at a large hospital in Zhejiang province, China. Methods:We investigated the relationships of blood inflammatory markers with hemostatic markers in 87 patients with T2DM who did not have complications and 95 patients with T2DM who had microvascular complications.Results: C-reactive protein (CRP) and interleukin-6 (IL-6) were significantly correlated with fibrinogen, thrombin-antithrombin III complex (TAT III), plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), and coagulation factors (F) VII in patients with T2DM who had microvascular complications (P <.05). Based on logistic regression analysis, the highest-tertile groups of fibrinogen, FVII, and FVIII, corresponded to a greater risk of high CRP, whereas risk of high IL-6 was significantly greater in the groups with highesttertile values for fibrinogen, FVII, TAT III, PAI-1, and activated protein C (APC).Conclusions: Elevated levels of CRP and IL-6 might be associated with increased coagulability and a tendency towards thrombus formation in patients with T2DM who have microvascular complications.

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“…Endothelial dysfunction (ED) is an early sign of atherosclerosis, it can be detected before coronary heart disease and other macrovascular complications of DM occur [8, 9], and it can be involved in the pathophysiology of cardiac abnormalities in these patients. The endothelium plays a central role in the regulation of arterial tone and blood flow, and it orchestrates the production of nitric oxide, prostacyclin, endothelium-derived hyperpolarizing factor, and vasoconstrictors such as endothelin-1 and angiotensin II [10].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Diastolic Function and Endothelial Function in Patients with Type 2 Diabetes and Hypertension

Bedirian

Neves

Oigman

et al. 2016

TOCMJ

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Background:Endothelial dysfunction may be involved in the pathophysiology of cardiac abnormalities in patients with diabetes mellitus (DM). A correlation between endothelial dysfunction and diastolic dysfunction in patients with type 1 DM has been demonstrated, but this relationship has not been well investigated in type 2 DM.Objective:Compare groups of patients with type 2 DM and hypertension with and without diastolic dysfunction using endothelial function indexes, and to assess whether correlations exist between the diastolic function and the endothelial function indexes.Method:This was a cross-sectional study of 34 men and women with type 2 DM and hypertension who were aged between 40 and 70 years and were categorized based on assessments of their Doppler echocardiographic parameters as having normal (14 patients) and abnormal (20 patients) diastolic function. Flow-mediated dilatation (FMD) assessments of the brachial artery evaluated the patients’ endothelial function.Results:The mean maximum FMD was 7.15 ± 2.80% for the patients with diastolic dysfunction and it was 11.85 ± 4.77% for the patients with normal diastolic function (p = 0.004). Correlations existed between the maximum FMD and the E/e' ratio (p = 0.040, r = -0.354) and the early wave velocity (e') at the lateral mitral annulus (p = 0.002, r = 0.509).Conclusion:The endothelial function assessed by FMD was worse in hypertensive diabetic patients with diastolic dysfunction. There were correlations between the diastolic function indexes and the endothelial function indexes in our sample.

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Investigation of endothelial dysfunction and arterial stiffness in children with type 1 diabetes mellitus and the association with diastolic dysfunction

Cited by 45 publications

References 31 publications

Evaluation of Cardiac Functions in Children and Adolescents with Type 1 Diabetes

Evaluation of Cardiac Functions in Children and Adolescents with Type 1 Diabetes

Associations Between Inflammatory Markers, Hemostatic Markers, and Microvascular Complications in 182 Chinese Patients With Type 2 Diabetes Mellitus

Correlation between Diastolic Function and Endothelial Function in Patients with Type 2 Diabetes and Hypertension

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