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Evaluation of left ventricular diastolic function in insulin dependent diabetic children by M-mode and Doppler
F Cerutti1, A Vigo, C Sacchetti
1Istituto di Clinica Pediatrica, University of Turin, Italy.
Insights
Diabetic children show early diastolic dysfunction, a sign of diabetic cardiomyopathy, even without symptoms. This cardiac issue is linked to longer diabetes duration and poorer blood sugar control.
Area of Science:
- Cardiology
- Endocrinology
- Pediatrics
Background:
- Diabetic cardiomyopathy is a potential complication in Type 1 diabetes.
- Early detection of cardiac dysfunction is crucial in pediatric patients.
Purpose of the Study:
- To assess left ventricular systolic and diastolic function in children with Type 1 diabetes mellitus (IDDM).
- To identify early signs of diabetic cardiomyopathy using non-invasive echocardiography.
Main Methods:
- M-mode and Doppler echocardiography were used to evaluate cardiac function in 50 children with IDDM.
- Diabetic children's cardiac parameters were compared to age-matched healthy controls.
Main Results:
- Diabetic children exhibited significantly prolonged pressure half time (PHT), indicating impaired early diastolic function.
- Higher PHT values correlated with longer IDDM duration and poorer glycemic control.
- Retinal microangiopathy was also considered in patient subgroup analysis.
Conclusions:
- Children with Type 1 diabetes can have early diastolic dysfunction, suggesting reduced left ventricular compliance.
- Doppler echocardiography is effective for non-invasively detecting early cardiac impairment in pediatric IDDM patients.
Abstract:
To evaluate the presence of diabetic cardiomyopathy, we measured various parameters of left ventricular systolic and diastolic function by means of M-mode and Doppler echocardiography in 50 IDDM children (mean age 13 +/- 3 years; mean IDDM duration 5.9 +/- 4.1 years) free of cardiovascular symptoms. As compared to age-matched healthy control subjects, diabetic children evidenced a significant increase in mean values of pressure half time (PHT), an index of the early diastolic phase (53.7 +/- 10.2 msec vs 44.5 +/- 9, p < 0.002). When the patients were subdivided on the basis of IDDM duration, metabolic control and the presence of retinal microangiopathic abnormalities, those with longer IDDM duration and poor glycemic balance had higher PHT values. These data indicate that an early diastolic dysfunction, expressed by reduced left ventricular compliance, can be found in children with Type 1 diabetes mellitus of relatively short duration. Doppler echocardiography is a reliable non-invasive means to assess early impairment of cardiac function in IDDM patients.