Subclinical left ventricular systolic and diastolic dysfunction in type 1 diabetic children and adolescents with good metabolic control

Yoldaş, Tamer; Örün, Utku Arman; Sağsak, Elif; Aycan, Zehra; Kaya, Özkan; Özgür, Senem; Karademir, Selmin

doi:10.1111/echo.13764

Cited by 36 publications

(29 citation statements)

References 37 publications

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“…13 As in the present study, there was no LVEF difference between severe and nonsevere CAD patients. Most used methods are checking for regional wall-motion anomalies or LVEF.…”

Section: Discussionsupporting

confidence: 65%

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3D‐speckle tracking echocardiography for assessment of coronary artery disease severity in stable angina pectoris

2018

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Background and Aim: Stable angina pectoris is a common disease that may cause disability. Some noninvasive new methods can be useful for the detection of earlystage coronary artery disease. The relationship between coronary artery disease (CAD) severity and resting 3-dimensional-speckle tracking echocardiography (3D-STE) in stable angina pectoris patients was evaluated in this study. Methods:One hundred and twenty consecutive patients between 18-80 years of age and without a history of CAD to whom elective coronary angiography was planned after positive stress test or myocardial perfusion scintigraphy were enrolled in the study. 3D-STE was performed and global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were measured before coronary angiography. A Gensini score of ≥20 was accepted as critical CAD. Correlation between Gensini scores and 3D-STE results were evaluated.Results: Mean age was 60.7 ± 10.01 years, and 55% of the patient population were male. There were not any significant differences between critical CAD and noncritical CAD groups for age, gender, history of hypertension, diabetes mellitus, hyperlipidemia, and Left Ventricular Ejection Fraction. Mean GLS was −12, GCS was −18.8, GRS was 33.4, GAS was −28.9, and mean Gensini score was 18.8. GLS and all other strain parameters were significantly worse in patients with critical CAD group compared with noncritical CAD group and also positive linear correlation was observed between Gensini score and all measured strain parameters (r = 0.568, P < 0.001 for Gensini score and GLS; r = 0.617, P < 0.001 for Gensini score and GAS). A GLS value of >−10 has 88.9% sensitivity and 92.9% specificity; A GAS value of >−21 has 97.2% sensitivity and 88.1% specificity to detect critical CAD.Conclusions: 3D-STE is a noninvasive and handy parameter to detect subclinical left ventricular dysfunction and global strain values were significantly correlated with CAD severity. GAS has the sensitivity of 97.2% and specificity of 88.1% to detect critical CAD. Adding 3D strain echocardiography to exercise test or myocardial perfusion scintigraphy might increase sensitivity to detect critical CAD in clinical practice. K E Y W O R D S3D -speckle tracking echocardiography, Gensini score, stable angina pectoris | 321 DOGDUS et al.

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“…13 As in the present study, there was no LVEF difference between severe and nonsevere CAD patients. Most used methods are checking for regional wall-motion anomalies or LVEF.…”

Section: Discussionsupporting

confidence: 65%

“…Previous studies had shown that LVEF is not a sensitive marker for subclinical dysfunction. 13 As in the present study, there was no LVEF difference between severe and nonsevere CAD patients. (61.4 ± 2.94 vs 62.1 ± 3.55 P: 0.742).…”

Section: Discussionsupporting

confidence: 63%

3D‐speckle tracking echocardiography for assessment of coronary artery disease severity in stable angina pectoris

2018

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“…27 In previous studies, LVEF was not found to be significantly different in T1DM patients compared with normal controls. [15][16][17][18]28 These findings suggest that LVEF decreases in the late period after the onset of T1DM. On color Doppler echocardiography, the A-wave velocity and e' in the D3 group decreased compared with the C3 group, which was similar to the results from previous reports.…”

Section: Conventional Parametersmentioning

confidence: 74%

In-Depth Insight Into the Mechanisms of Cardiac Dysfunction in Patients With Type 1 Diabetes Mellitus Using Layer-Specific Strain Analysis

Iso

Takahashi

Yazaki

et al. 2019

Circ J

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Background: Although the subclinical left ventricular (LV) dysfunction caused by diabetes mellitus (DM) results in a high risk of death and heart failure, the details of cardiac dysfunction across a wide age range remain unclear. The aim of this study was to assess LV dysfunction in patients with type 1 DM (T1DM) using layer-specific strain analysis by echocardiography. Methods and Results: The 52 patients (median age: 23 [range: 5-40] years) with T1DM were divided into 3 age groups (D1: 5-14 years, D2: 15-24 years, D3: 25-40 years); 78 age-and sex-similar controls were divided into 3 corresponding groups (C1, C2, and C3). Layer-specific longitudinal strain (LS) and circumferential strain (CS) of the 3 myocardial layers (endocardium, midmyocardium, and epicardium) were determined using echocardiography. Strains did not decrease in D1. Epicardial and midmyocardial CS at the basal level and LS in all layers were decreased in D2 compared with C2. CS at the basal level and LS in all layers were lower in D3 than in C3. The strains correlated with the duration of T1DM and LV wall thickness. Conclusions: In patients with T1DM, longitudinal deformation in all layers and epicardial and midmyocardial circumferential deformation at the basal level decreased from the late teens, which correlated with the duration of the disease and LV hypertrophy.

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“…Bu süreç, hipergliseminin sürekli olması durumunda kardiak disfonksiyon gelişimine zemin hazırlamaktadır [20]. İyi glisemik kontrollü Tip 1 diyabetli çocuk ve adolesanlarda yapılan bir çalışmada dahi sol ventrikül diyastolik fonksiyonlarında azalma olduğu bulunmuştur [21]. Asemptomatik olan tip 1 diyabetli çocuklarda yapılan bazı çalışmalarda, subklinik olarak sol ventrikül sistolik fonksiyonunun göstergesi olan EF değerinde anlamlı azalma olduğu gösterilmiştir.…”

Section: Discussionunclassified

Early Evaluation of Cardiac Functions by Conventional Echocardiography in Children and Adolescents with Type 1 Diabetes

Çetiner

Bolu

Almış

et al. 2020

Zeynep Kamil Tıp Bülteni

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Kardiyak disfonksiyonun tip 1 diyabetin ciddi ve sık görülen komplikasyonlarından biri olduğu bilinmektedir. Bu çalışmanın amacı, tip 1 diyabet tanılı çocuk ve adolesanların kardiyak etkilenmenin konvansiyonel ekokardiyografi ile erken dönemde değerlendirilmesiydi. Gereçler ve Yöntem: Çalışmada 53 tip 1 Diyabet tanılı çocuk ve adolesan ile benzer yaş ve cinsiyette 55 sağlıklı çocuk ve adolesan yer almaktadır. Katılımcıların, boy, kilo, vücut kitle indeksi ve kan basıncı değerleri kaydedildi. Tip 1 diyabetli hasta grubunda glisemik kontrol için glikolize hemoglobin ölçümü yapıldı. Tüm katılımcıların miyokardiyal sistolik ve diyastolik fonksiyonları konvansiyonel ekokardiyografi yöntemi ile değerlendirildi. Bulgular: Tip 1 diyabetli 53 hastada kontrol grubuna göre triküspid kapağın A dalga akım hızı anlamlı yüksek (p=0,04) ve triküspid E/A oranı ise anlamlı düşük (p=0,02) bulundu. Sol ventrikül fraksiyonel kısalma ve ejeksiyon fraksiyonu hasta grubunda kontrole göre daha düşük bulundu, ancak istatiksel olarak anlamlı değildi (p değerleri sırasıyla 0,675, 0,933). Hasta grubunda glikolize hemoglobin düzeyi ile sol ventrikül sistolik fonksiyonu arasında ise istatiksel olarak anlamlı negatif korelasyon bulundu (p= 0,049, r=-0,669). Sonuç: Tip 1 diyabet tanısı olan çocuk ve adolesanlarda erken dönemde bile ekokardiyografik olarak sağ ventrikülde diyastolik disfonksiyon ve glikolize hemoglobin düzeyi ile sol ventrikül ejeksiyon fraksiyonu arasında negatif korelasyonun gösterilmesi, kötü glisemik kontrollü diyabetik hastaların peryodik olarak kardiyak değerlendirmelerinin noninvazif tanı yöntemi olan ekokardiyografi ile yapılmasının gerekli olduğunu düşündürmektedir.

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Subclinical left ventricular systolic and diastolic dysfunction in type 1 diabetic children and adolescents with good metabolic control

Cited by 36 publications

References 37 publications

3D‐speckle tracking echocardiography for assessment of coronary artery disease severity in stable angina pectoris

3D‐speckle tracking echocardiography for assessment of coronary artery disease severity in stable angina pectoris

In-Depth Insight Into the Mechanisms of Cardiac Dysfunction in Patients With Type 1 Diabetes Mellitus Using Layer-Specific Strain Analysis

Early Evaluation of Cardiac Functions by Conventional Echocardiography in Children and Adolescents with Type 1 Diabetes

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