Evaluation of left ventricular functions with two-dimensional speckle-tracking echocardiography (2D-STE) and N-terminal ProBNP in diabetic children.

Şimşek A, Turan Ö, Çiftel M, Kardelen F, Durmaz E, Özdem S, Akçurin G, Ertuğ H. Evaluation of left ventricular functions with twodimensional speckle-tracking echocardiography (2D-STE) and N-terminal ProBNP in diabetic children. Turk J Pediatr 2018; 60: 633-641. The purpose of this study was to examine the existence of subclinical left ventricular dysfunction by using 2D-STE and NT-ProBNP levels in children and adolescent patients with type 1 diabetes mellitus. Furthermore, it was also aimed to investigate the effects of the diabetes duration and the metabolic control of the disease on cardiac functions. The patient group was composed of 63 children who were being followed up for the type 1 diabetes mellitus. The control group was composed of 36 healthy children who were of the similar age. Patients with type 1 diabetes mellitus were divided into groups; according to the duration of the disease; group 1: 3-5 years, group 2: 6-10 years of follow-up. The conventional echocardiography and 2D-STE were applied to all of the patients and control individuals. NT-Pro BNP level was measured in the diabetes group. In the conventional echocardiographic examination; there was no difference between the patient and control groups in terms of left ventricular systolic functions, left ventricular diastolic functions; late-diastolic flow velocity in mitral valve (A) values increased and E-wave/A-wave ratio (E/A ) values decreased in diabetes mellitus patients. According to the 2D-STE results; global longitudinal strain, (-17.28±2.24 vs. -19.49±2.22; p < 0.05) and circumferential strain (-12.86±3.19 vs. -17.71±4.62; p < 0.05) were lower in diabetic patients compared to the parameters of control group individuals. There was no difference between levels of NT-ProBNP of the group 1 and group 2 diabetes mellitus patients. Our study showed that there was a dysfunction on the left ventricular systolic functions of the patients with type 1 diabetes mellitus. NT-Pro BNP levels were not considered as a distinguishing factor for the early stages of diabetes mellitus.