Khattab Ahmed Anwer, Soliman Mahmoud Ali
Pediatrics Department, Faculty of Medicine, Menoufyia University Hospital, Sheebin El-Kom, Egypt,
Pediatr Cardiol. 2015 Feb;36(2):423-31. doi: 10.1007/s00246-014-1030-3. Epub 2014 Oct 11.
To assess right- and left-ventricular function in children with type 1 diabetes mellitus (DM) as well as correlate cardiac function with diabetes duration and state of metabolic control. The present study included 30 patients with type 1 DM (group 1) and 20 apparently normal children with comparable age and sex as controls (group 2). All children were subjected to detailed history, clinical examination, and routine laboratory investigations, including glycated hemoglobin, as well as conventional echocardiographic and tissue Doppler examination. Children with type 1 DM have impaired diastolic function in both left and right ventricles before the development of systolic dysfunction when assessed with either conventional or tissue Doppler echocardiography. Resting heart rate in diabetic patients showed a significant positive correlation with mitral A flow velocity and a significant negative correlation with mitral and tricuspid E/A ratio. Regarding morphological parameters of the left ventricle, all dimensions and volumes were comparable between diabetic patients and controls; however, a significant positive correlation was found between interventricular septal thickness at diastole (IVSd), interventricular septal thickness at systole (IVSs), and left ventricular posterior wall at systole (LVPWs) and the duration of diabetes. Children with type 1 DM have impaired diastolic function in both left and right ventricles with normal systolic function when assessed with either conventional or tissue Doppler echocardiography.
评估1型糖尿病(DM)患儿的右心室和左心室功能,并将心脏功能与糖尿病病程及代谢控制状态相关联。本研究纳入了30例1型糖尿病患者(第1组)和20例年龄及性别匹配的明显正常儿童作为对照(第2组)。所有儿童均接受了详细的病史询问、临床检查以及常规实验室检查,包括糖化血红蛋白,同时还进行了传统超声心动图和组织多普勒检查。当采用传统或组织多普勒超声心动图评估时,1型糖尿病患儿在出现收缩功能障碍之前,左心室和右心室的舒张功能均已受损。糖尿病患者的静息心率与二尖瓣A峰流速呈显著正相关,与二尖瓣和三尖瓣E/A比值呈显著负相关。关于左心室的形态学参数,糖尿病患者和对照组之间所有的内径和容积均具有可比性;然而,舒张末期室间隔厚度(IVSd)、收缩期室间隔厚度(IVSs)和收缩期左心室后壁厚度(LVPWs)与糖尿病病程之间存在显著正相关。当采用传统或组织多普勒超声心动图评估时,1型糖尿病患儿的左心室和右心室舒张功能受损,但收缩功能正常。