Background: Tissue Doppler echocardiography can predict early stages and progression of diabetic cardiac changes; especially ventricular dysfunction, a complication that adversely affect the quality of life and prognosis of the disease.
Objective and hypotheses: The aim of this study was to assess systolic and diastolic functions of both ventricles in type 1 diabetes (T1D) patients by conventional and Tissue Doppler echocardiography, and to correlate cardiac dysfunction with presence of hypertension, hyperlipidemia, and autonomic neuropathy.
Method: A cross sectional study included 40 children and adolescents, 616 years old with T1D more than 5 years duration, following in the Diabetes, Endocrine Metabolic Pediatric unit, Children Hospital, Cairo University. 20 healthy age and sex matched children were included as controls. Anthropometric measurements, systolic and diastolic blood pressure measurement:supine, sitting and standing for detection of autonomic dysfunction, episodic hypertension and orthostatic hypertension. Laboratory assessment including glycosylated haemoglobin and lipid profile were done. 12 lead Electrocardiography, M mode echocardiography, conventional echocardiography and tissue Doppler assessment were performed. The latter was used to measure Myocardial peak systolic (Sm), early diastolic filling (Em) and late diastolic atrial filling (Am) velocities.
Results: Among diabetic patients, 12.5% had right ventricular diastolic dysfunction and 12.5% had left ventricular diastolic dysfunction. No association was found between diastolic dysfunction on one hand and either duration of diabetes or HbA1c on the other hand. Isovolumic Relaxation time and Myocardial performance index of right ventricle were found significantly higher in diabetic patients (43.8±6.37, 0.31±0.07 respectively) compared to controls (35.76±9.5, 0.27±0.06 respectively) with a P-value of (0.001, 0.049 respectively).
Conclusion: Assessment by tissue Doppler is warranted in patients with T1D to follow the progression from subclinical to symptomatic ventricular dysfunction. Further studies are needed to further explore the role of tissue Doppler in assessing cardiovascular complications of T1D.
Conflict of interest: The author declares that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
01 Oct 2015 - 03 Oct 2015