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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular mechanics are affected in children with celiac disease: A study based on two-dimensional speckle
Murat Deveci1, Ayşen Uncuoğlu Aydoğan2, Gürkan Altun3
1Department of Pediatric Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Insights
Children with celiac disease (CD) show reduced cardiac mechanics, detectable by two-dimensional speckle tracking echocardiography (2DSTE). This advanced imaging method is superior for identifying subclinical carditis in pediatric CD patients.
Area of Science:
- Pediatric Cardiology
- Gastroenterology
- Medical Imaging
Background:
- Celiac disease (CD) is an autoimmune disorder with known extraintestinal manifestations.
- While cardiac involvement in CD is rarely reported, its subclinical impact on cardiac mechanics in children remains understudied.
- This study investigates cardiac function in children diagnosed with celiac disease.
Purpose of the Study:
- To evaluate the effects of celiac disease on cardiac mechanics in children.
- To compare the efficacy of two-dimensional speckle tracking echocardiography (2DSTE) with conventional echocardiography and tissue Doppler imaging (TDI) in detecting cardiac abnormalities in pediatric CD patients.
- To assess differences in cardiac function between children with CD and healthy controls, and between subgroups of CD patients based on serological markers.
Main Methods:
- Eighty-one children with CD and 51 healthy children underwent comprehensive echocardiographic examinations.
- Cardiac function was assessed using conventional echocardiography, TDI, and 2DSTE.
- Children with CD were stratified into two groups: those positive for serum antitissue transglutaminase antibody (n=48) and those negative (n=33), with a subgroup analysis for those on a gluten-free diet for over 6 months.
Main Results:
- No significant differences in age or sex distribution were observed between the CD and control groups.
- Conventional echocardiography and TDI measurements did not reveal significant differences between groups.
- Significantly lower left ventricular longitudinal and radial strains, and strain rate values were found in children with CD, especially in the seropositive subgroup, compared to controls.
Conclusions:
- Two-dimensional speckle tracking echocardiography (2DSTE) demonstrates superior sensitivity in detecting subclinical cardiac abnormalities in children with celiac disease compared to conventional echocardiography and TDI.
- Subclinical carditis may be present in children with celiac disease, particularly those with active serological markers.
- 2DSTE is a valuable tool for the early detection and monitoring of cardiac involvement in pediatric celiac disease.
Background:
An association between cardiomyopathy and celiac disease has been reported, but not frequently. We examined the effects on cardiac mechanics in children with celiac disease (CD) by two-dimensional speckle tracking echocardiography (2DSTE).
Methods:
Eighty-one children with CD were compared with a control group comprising 51 healthy children by echocardiographic examination. Children with CD who had been on gluten-free diet for more than 6 months were divided into two different groups: group 1 was positive for serum antitissue transglutaminase antibody (n=48), and group 2 was negative for serum antitissue transglutaminase antibody (n=33). Cardiac functions were evaluated in all children using conventional echocardiography, tissue Doppler imaging (TDI), and 2DSTE methods.
Results:
For children with CD, the mean age and male:female ratio were 10.1±4.0 years and 26/55 (67% female), respectively, which did not differ from the controls. Patients were diagnosed at a mean age of 7.9±4.1 years, and the mean follow-up time was 2.37±2.98 years. Conventional echocardiography and TDI measurements did not differ between groups. The left ventricular longitudinal and radial strains, and strain rate values were significantly lower in patients with CD, particularly in those with positive antitissue transglutaminase antibody compared with the control group.
Conclusions:
Our results suggest that 2DSTE is superior to conventional and TDI echocardiography for evaluating subclinical carditis in children with CD.
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