Children with untreated coeliac disease have sub-clinical cardiac dysfunction: a longitudinal observational analysis

Area of Science:

• Pediatric Cardiology
• Gastroenterology
• Clinical Echocardiography

Background:

• Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
• Cardiac function (CF) alterations may be present in children with CD.
• The impact of a gluten-free diet (GFD) on cardiac function in pediatric CD is not fully understood.

Purpose of the Study:

• To assess cardiac function in children diagnosed with celiac disease.
• To evaluate the effects of a gluten-free diet on cardiac function in pediatric celiac disease patients.

Main Methods:

• Prospective echocardiographic evaluation of 50 CD patients at diagnosis and after one year of GFD.
• Comparison with 100 CD children in follow-up (compliant and non-compliant) and 25 healthy controls.
• Utilized conventional and tissue Doppler echocardiography to assess cardiac parameters.

Main Results:

• Untreated CD children exhibited impaired cardiac function, including larger left ventricle dimensions and reduced ejection fraction compared to controls.
• After one year of GFD, compliant patients showed significant improvements in diastolic function parameters like isovolumic relaxation time and deceleration time.
• Gluten-free diet compliant patients had a lower myocardial performance index (MPI) than non-compliant patients, indicating improved load-independent cardiac function.

Conclusions:

• Subclinical cardiac dysfunction is prevalent in children with celiac disease at diagnosis.
• A gluten-free diet leads to improvements in echocardiographic parameters, suggesting recovery of cardiac function.
• Persistent cardiac dysfunction is observed in pediatric celiac disease patients who do not adhere to a gluten-free diet.