Subclinical Cardiac Dysfunction in Children with Coeliac Disease: Is the Gluten-Free Diet Effective?

Abstract

Objectives. The aim of this study is to investigate the effects of coeliac disease on cardiac function in children using conventional transthoracic echocardiography (TTE) and tissue Doppler echocardiography (TDE). Methods. Coeliac disease patients were evaluated in two different groups based on serum endomysial antibody (EmA) titers (EmA (+) and EmA (−)), and the data obtained by conventional and TDE studies were compared between the patient groups and healthy controls. Results. There was no significant difference between EmA (+) and EmA (−) groups in terms of the conventional TTE parameters, including ejection fraction (EF), fractional shortening (FS), and left ventricle end diastolic diameter (LVEDD), that show the left ventricular systolic function (P = 0.727, P = 0.317, P = 0.118). TDE showed a significant difference in left ventricle (LV) isovolumic relaxation time (LV IVRT) and LV myocardial performance index (LV MPI) parameters between EmA (+) and EmA (−) patient groups (P < 0.0001). Conclusion. The measurement of LV MPI and LV IVRT parameters by TDE would be beneficial in early determination of the cardiac involvement and establishing appropriate treatment and followup of patients with coeliac disease as well as in making distinction between EmA (+) and EmA (−) patients.

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.…”

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

“…Saylan et al . [23] reported no significant difference between CD children and healthy controls regarding the ejection fraction and FS parameters, however, the interventricularseptal systolic dimension (IVSD) and LV end diastolic diameter (LVEDD) parameters were significantly different between EMA (+) and EMA (−) groups as well as the control group. Lionetti et al .,[24] in a study among 40 children with CD, using two-dimensional and M-mode echocardiography detected mild cardiac affection in 9 out of 40 patients in the form of mitral valve regurgitation (5 patients), aortic valve regurgitation (2 patients), pulmonary and tricuspid valve regurgitation (1 patient), and low ejection fraction (1 patient).…”

“…Furthermore, Saylan et al . [23] reported a significant difference in DTI parameters including mitral valve early diastolic (Em) velocity, mitral valve late diastolic (Am) velocity, mitral Em/Am ratio, tricuspid valve early diastolic (Em) velocity, and LV myocardial performance index between CD patients and the control groups.…”

The subclinical effect of celiac disease on the heart and the effect of gluten-free diet on cardiac functions

“…Cevik et al 3 reported that, the TDE parameters of LV myocardial performance index (MPI) and LV IVRT were effective in patients with CD.…”

“…Besides, cardiovascular system pathologies such as myocarditis and idiopathic dilated cardiomyopathy (IDCM) have also been found to be associated with CD 2 . These studies about CD suggest that subclinical involvement of cardiovascular system is much more frequent than IDCM and myocarditis 3,4 .…”