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The evaluation of left ventricular functions with tissue doppler echocardiography in adults with celiac disease
Fatma E Akin, Cenk Sari1, Sevil Ozer-Sari
1Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Insights
Celiac disease (CD) impairs cardiac function, affecting both diastolic and systolic myocardial performance. Tissue Doppler echocardiography (TDE) reveals these subtle cardiac changes in CD patients.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Imaging
Background:
- Celiac disease (CD) is an autoimmune disorder affecting the small intestine.
- Potential extra-intestinal manifestations, including cardiac involvement, are increasingly recognized.
Purpose of the Study:
- To investigate the impact of celiac disease on cardiac function.
- To evaluate the utility of tissue Doppler echocardiography (TDE) in assessing cardiac performance in CD patients.
Main Methods:
- A comparative study involving 30 CD patients and 30 healthy controls.
- Echocardiographic assessments using conventional methods and TDE.
- Measurement of various myocardial velocities, timings, and ratios including S'm, E'm, A'm, E'm/A'm, PCT'm, CT'm, IVRT'm, and E to E'm ratio.
Main Results:
- CD patients exhibited significantly higher mitral late diastolic flow (A) velocity and E to E'm ratio, lower E/A ratio, and prolonged isovolumetric relaxation time (IVRT).
- TDE revealed significantly lower peak systolic (S'm) and early diastolic (E'm) myocardial velocities, and reduced E'm/A'm ratios from both septal and lateral mitral annuli in CD patients.
- Impaired myocardial systolic function was indicated by lower S'm and prolonged myocardial precontraction time (PCT'm) and isovolumetric relaxation time (IVRT'm) in the celiac group.
Conclusions:
- Celiac disease is associated with impaired diastolic myocardial function.
- TDE demonstrates an additional impairment of myocardial systolic function in CD patients.
- TDE is recommended for comprehensive cardiovascular risk assessment in individuals with celiac disease.
Background/Aim:
The aim of this study was to investigate the effects of celiac disease on cardiac functions using tissue Doppler echocardiography (TDE).
Patients And Methods:
The study included 30 patients with celiac disease (CD) and 30 healthy volunteers. Echocardiographic examinations were assessed by conventional echocardiography and tissue Doppler imaging. The peak systolic velocity (S'm), early diastolic myocardial peak velocity (E'm), late diastolic myocardial peak velocity (A'm), E'm/A'm ratio, myocardial precontraction time (PCT'm), myocardial contraction time (CT'm), and myocardial isovolumetric relaxation time (IVRT'm), E to E'm ratio were measured.
Results:
In pulsed wave Doppler echocardiography, mitral late diastolic flow (A) velocity and E to E'm ratio were significantly higher (P = 0.02 and P = 0,017), E/A ratio was significantly lower (P = 0.008) and IVRT was significantly prolonged (P = 0.014) in patients with CD. In TDE, S'm, E'm, and E'm/A'm ratio were significantly lower, IVRT'm was longer (P = 0.009) from septal mitral annulus and S'm, E'm, E'm/A'm ratio were significantly lower, PCT'm, PCT/ET ratio, IVRT'm were longer, and MPI was higher from lateral mitral annulus in celiac group than controls.
Conclusion:
Our study confirms that patients with CD have impaired diastolic function. More importantly, we also demonstrated an impairment of myocardial systolic function in patients with CD by TDE. We recommend using TDE in addition to conventional echocardiography parameters for the cardiovascular risk assessment of patients with CD.
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