Subclinical cardiac dysfunction in children with coeliac disease: is the gluten-free diet effective?

Area of Science:

• Pediatric Cardiology
• Gastroenterology
• Diagnostic Imaging

Background:

• Coeliac disease (CD) is an autoimmune disorder affecting the small intestine.
• Cardiac function can be subtly affected in CD, necessitating sensitive diagnostic tools.
• Early detection of cardiac involvement in pediatric CD is crucial for timely intervention.

Purpose of the Study:

• To evaluate cardiac function in children with coeliac disease using transthoracic echocardiography (TTE) and tissue Doppler echocardiography (TDE).
• To compare cardiac parameters between coeliac disease patients with different endomysial antibody (EmA) titers and healthy controls.

Main Methods:

• Coeliac disease patients were categorized into EmA-positive (EmA (+)) and EmA-negative (EmA (-)) groups.
• Conventional TTE parameters (ejection fraction, fractional shortening, LVEDD) were assessed.
• Tissue Doppler echocardiography (TDE) was used to measure left ventricle (LV) isovolumic relaxation time (LV IVRT) and LV myocardial performance index (LV MPI).

Main Results:

• No significant differences in conventional TTE parameters (systolic function) were observed between EmA (+) and EmA (-) groups.
• TDE revealed significant differences in LV IVRT and LV MPI between EmA (+) and EmA (-) patient groups (P < 0.0001).

Conclusions:

• TDE parameters, specifically LV MPI and LV IVRT, are sensitive indicators of cardiac involvement in pediatric coeliac disease.
• TDE can aid in the early determination of cardiac involvement and differentiate between EmA (+) and EmA (-) coeliac disease patients.
• These findings support the use of TDE for monitoring and managing cardiac health in children with coeliac disease.