Poor glycemic control in children with type 1 diabetes was associated with a higher rate of type 1 diastolic dysfunction by tissue Doppler echocardiography compared to well-controlled patients (40.4% vs 18%).
Observational
Does glycemic control affect left and right ventricular functions assessed by echocardiography in children with type 1 diabetes mellitus?
Impairment in left ventricular diastolic function is directly related to glycemic control in children with type 1 diabetes, and tissue Doppler imaging is more sensitive than conventional Doppler for detecting these early changes.
Absolute Event Rate: 40.4% vs 18%
BACKGROUND: The aim of the study was the evaluation of the effects of glycemic control in children and adolescents with type 1 diabetes on cardiac functions. METHODS: Diabetic patients were divided into two groups as well-controlled and poorly controlled patients. All patients underwent M-mode, two-dimensions (2D), pulsed wave (PW) Doppler, and tissue Doppler (TDI) echocardiography to evaluate systolic and diastolic functions. RESULTS: Early diastolic mitral flow velocity (Em) and the ratio of early to late diastolic mitral flow velocity (Em/Am) obtained with TDI were found to be significantly lower in the well-controlled then the control group and significantly lower in the poorly-controlled group than the well-controlled group. Am, isovolumetric relaxation time (IVRT) and myocardial performance index (MPI) were significantly higher in the poorly controlled group. The ratio of early mitral diastolic flow velocity obtained with PW Doppler (E) to Em (E/Em) was significantly higher in the diabetic group. According to the mitral valve PW Doppler results, 13.6% of the well-controlled group and 31% of the poorly-controlled group had type 1 diastolic dysfunction. According to the mitral TDI results, 18% of the well-controlled group and 40.4% of poorly-controlled group had type 1 diastolic dysfunction. CONCLUSIONS: Conventional and TDI echocardiography revealed impairment in left ventricular functions in some patients. Tissue Doppler echocardiography also revealed diastolic impairment in some patients who appeared normal with PW Doppler echocardiography. The present study found that impairment in left ventricular diastolic functions is directly related to glycemic control and the rate of diabetic cardiomyopathy was higher in children with poor metabolic control.
Acar et al. (Sat,) conducted a observational in Type 1 diabetes mellitus. Poor glycemic control vs. Well-controlled glycemic control was evaluated on Type 1 diastolic dysfunction by mitral tissue Doppler echocardiography. Poor glycemic control in children with type 1 diabetes was associated with a higher rate of type 1 diastolic dysfunction by tissue Doppler echocardiography compared to well-controlled patients (40.4% vs 18%).