Division of Pediatric Cardiology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey.
Department of Pediatrics, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey.
Cardiol Young. 2023 Apr;33(4):603-607. doi: 10.1017/S1047951122001408. Epub 2022 May 16.
This study aimed to evaluate the role of real-time three-dimensional (known as four-dimensional) echocardiography and three-dimensional speckle-tracking echocardiography for the early detection of left ventricular systolic dysfunction in asymptomatic children with type 1 diabetes mellitus.
This cross-sectional study included 38 patients (mean age 15.4 ± 2.9, 42.1% male) and 38 age, gender, and body measurements matched healthy children. Each patient underwent an interview about medical history, a detailed clinical examination, blood laboratory tests, conventional echocardiography, and tissue Doppler imaging. Left ventricular ejection fraction; global longitudinal, circumferential, radial strain; twist; and torsion were measured by real-time three-dimensional and speckle-tracking echocardiography.
Conventional echocardiography and tissue Doppler imaging showed normal left ventricular systolic function in the patients. Although left ventricular ejection fraction (61.6 ± 1.4%, 61.8 ± 1.1%, p = 0.386), global longitudinal [-26.6 (-27.7 to -26.1)%, -26.2 (-27.7 to -24.9)%, p = 0.224], and radial strain [44.4 (42.4-45.9)%, 43.9 (41-46.1)%, p = 0.513] were similar to the controls, circumferential strain (-27.3 ± 1.3%, -28.0 ± 1.6%, p = 0.048) and twist (9.5 ± 2.3°, 11.4 ± 3.0°, p = 0.003) were decreased in the patients compared with controls.
We found that even in children with asymptomatic type 1 diabetes mellitus with normal left ventricular ejection fraction, circumferential function was impaired and rotation pattern was changed. This novel echocardiographic method might be an important tool for detecting left ventricular systolic dysfunction in type 1 diabetes mellitus children before it becomes overt on conventional echocardiography and tissue Doppler imaging.
本研究旨在评估实时三维（又称四维）超声心动图和三维斑点追踪超声心动图在无症状 1 型糖尿病患儿左心室收缩功能障碍早期检测中的作用。
这项横断面研究纳入了 38 名患者（平均年龄 15.4 ± 2.9 岁，42.1%为男性）和 38 名年龄、性别和身体测量匹配的健康儿童。每位患者均接受了病史访谈、详细的临床检查、血液实验室检查、常规超声心动图和组织多普勒成像检查。实时三维和斑点追踪超声心动图测量左心室射血分数、整体纵向、环向、径向应变、扭转和扭转。
患者的常规超声心动图和组织多普勒成像显示左心室收缩功能正常。尽管左心室射血分数（61.6 ± 1.4%，61.8 ± 1.1%，p = 0.386）、整体纵向应变[-26.6（-27.7 至-26.1）%，-26.2（-27.7 至-24.9）%，p = 0.224]和径向应变[44.4（42.4-45.9）%，43.9（41-46.1）%，p = 0.513]与对照组相似，但环向应变（-27.3 ± 1.3%，-28.0 ± 1.6%，p = 0.048）和扭转（9.5 ± 2.3°，11.4 ± 3.0°，p = 0.003）在患者中较对照组降低。
我们发现，即使在无症状 1 型糖尿病患儿中，即使左心室射血分数正常，其环向功能也会受损，旋转模式也会发生改变。这种新的超声心动图方法可能是在常规超声心动图和组织多普勒成像检测到 1 型糖尿病患儿左心室收缩功能障碍之前，检测左心室收缩功能障碍的重要工具。
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