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Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study.
BMC Cardiovasc Disord. 2016 05 25; 16:103.BC

Abstract

BACKGROUND

Reduced diastolic myocardial function is an early sign of diabetic cardiomyopathy. The aim of this study was to test the hypothesis that children and adolescents with type 1 diabetes mellitus (T1D), but without other known complications, have early reduced diastolic myocardial function diagnosed with echocardiographic color tissue Doppler imaging (cTDI).

METHODS

cTDI examination was carried out in 173 T1D patients and 62 age-matched controls. The T1D-patients were 8-18 years old with (mean (SD)) diabetes duration of 5.6 (3.4) years and HbA1c of 8.4 (1.3). All were treated with either insulin pumps or 4-6 daily insulin injections. cTDI early (E') and late (A') peak diastolic velocities and systolic peak velocity were measured from the lateral, septal, anterior and posterior mitral annulus and from the lateral tricuspidal annulus.

RESULTS

Myocardial diastolic function was reduced in the T1D-patients with higher peak A'-velocity and lower E'/A'-ratio in all registrations. Overall mean (SD) mitral E'/A'-ratio was 2.3 (0.5) in T1D and 2.7 (0.6) in the controls (p < 0001). The overall mitral E'/A'-ratio was negative associated with blood pressure (BP) and body mass index (BMI). Stratifying all participants into three groups according to BMI (<25, 25-75, >75 centile, respectively), the T1D had lower E'/A'-values in all stratified groups, except for in the highest BMI-group where both T1D and controls had the lowest E'/A'-ratio. Systolic function did not differ in any of the measurements. There were no associations with sex, diabetes duration, carotid artery intima-media-thickness, vessel elasticity or HbA1c.

CONCLUSION

Diabetic children and adolescents using modern intensive insulin treatment had echocardiographic signs of reduced diastolic myocardial function despite short duration of disease. The reduced function was associated with higher BP and higher BMI.

Authors+Show Affiliations

Department of Pediatrics, Section for Heart Diseases, Oslo University Hospital, Oslo, Norway. leifbrunvand@hotmail.com.Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.Department of Radiology and Nuclear medicine, Institute of Circulation and Imaging, Norwegian University of Science and Technology and St Olavs University Hospital, Trondheim, Norway.Department of Pediatrics, Section for Heart Diseases, Oslo University Hospital, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.Department of Pediatrics, Akershus University Hospital, Nordbyhagen, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27225446

Citation

Brunvand, Leif, et al. "Early Reduced Myocardial Diastolic Function in Children and Adolescents With Type 1 Diabetes Mellitus a Population-based Study." BMC Cardiovascular Disorders, vol. 16, 2016, p. 103.
Brunvand L, Fugelseth D, Stensaeth KH, et al. Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study. BMC Cardiovasc Disord. 2016;16:103.
Brunvand, L., Fugelseth, D., Stensaeth, K. H., Dahl-Jørgensen, K., & Margeirsdottir, H. D. (2016). Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study. BMC Cardiovascular Disorders, 16, 103. https://doi.org/10.1186/s12872-016-0288-1
Brunvand L, et al. Early Reduced Myocardial Diastolic Function in Children and Adolescents With Type 1 Diabetes Mellitus a Population-based Study. BMC Cardiovasc Disord. 2016 05 25;16:103. PubMed PMID: 27225446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study. AU - Brunvand,Leif, AU - Fugelseth,Drude, AU - Stensaeth,Knut Håkon, AU - Dahl-Jørgensen,Knut, AU - Margeirsdottir,Hanna Dis, Y1 - 2016/05/25/ PY - 2016/01/28/received PY - 2016/05/14/accepted PY - 2016/5/27/entrez PY - 2016/5/27/pubmed PY - 2017/10/4/medline KW - Blood pressure KW - Body mass index KW - Diabetes type-1 KW - Diastolic myocardial function KW - Echocardiography KW - Tissue Doppler imaging SP - 103 EP - 103 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 16 N2 - BACKGROUND: Reduced diastolic myocardial function is an early sign of diabetic cardiomyopathy. The aim of this study was to test the hypothesis that children and adolescents with type 1 diabetes mellitus (T1D), but without other known complications, have early reduced diastolic myocardial function diagnosed with echocardiographic color tissue Doppler imaging (cTDI). METHODS: cTDI examination was carried out in 173 T1D patients and 62 age-matched controls. The T1D-patients were 8-18 years old with (mean (SD)) diabetes duration of 5.6 (3.4) years and HbA1c of 8.4 (1.3). All were treated with either insulin pumps or 4-6 daily insulin injections. cTDI early (E') and late (A') peak diastolic velocities and systolic peak velocity were measured from the lateral, septal, anterior and posterior mitral annulus and from the lateral tricuspidal annulus. RESULTS: Myocardial diastolic function was reduced in the T1D-patients with higher peak A'-velocity and lower E'/A'-ratio in all registrations. Overall mean (SD) mitral E'/A'-ratio was 2.3 (0.5) in T1D and 2.7 (0.6) in the controls (p < 0001). The overall mitral E'/A'-ratio was negative associated with blood pressure (BP) and body mass index (BMI). Stratifying all participants into three groups according to BMI (<25, 25-75, >75 centile, respectively), the T1D had lower E'/A'-values in all stratified groups, except for in the highest BMI-group where both T1D and controls had the lowest E'/A'-ratio. Systolic function did not differ in any of the measurements. There were no associations with sex, diabetes duration, carotid artery intima-media-thickness, vessel elasticity or HbA1c. CONCLUSION: Diabetic children and adolescents using modern intensive insulin treatment had echocardiographic signs of reduced diastolic myocardial function despite short duration of disease. The reduced function was associated with higher BP and higher BMI. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/27225446/Early_reduced_myocardial_diastolic_function_in_children_and_adolescents_with_type_1_diabetes_mellitus_a_population_based_study_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-016-0288-1 DB - PRIME DP - Unbound Medicine ER -