Key result
Children with type 1 diabetes had higher median daytime diastolic BP loads than controls (12.35 vs 2.5, p=0.007), which correlated with increased BNP and abnormal tissue Doppler indices.
Why the study?
Are elevated blood pressure loads detected by 24-h ABPM associated with early diastolic dysfunction and increased BNP levels in children with type 1 diabetes mellitus?
Observational (n=50)
Are elevated blood pressure loads detected by 24-h ABPM associated with early diastolic dysfunction and increased BNP levels in children with type 1 diabetes mellitus?
Elevated blood pressure loads detected by 24-h ABPM in children with type 1 diabetes are associated with increased BNP levels and abnormal tissue Doppler indices, suggesting early-stage cardiac dysfunction.
ABPM BP loads associate with early diastolic markers in pediatric T1DM; leaves open screening utility and prospective validation.
AIM: To evaluate the relationship between 24-h blood pressure (BP) measurements and diastolic heart function evaluated by Doppler tissue imaging and B-type natriuretic peptide (BNP) levels in children with type 1 diabetes mellitus (DM). PATIENTS AND METHODS: A total of 32 diabetic and 18 healthy children were enrolled. Spectral Doppler analysis and tissue Doppler measurements were performed by conventional echocardiography. The 24-h ambulatory BP and serum BNP levels were measured. RESULTS: Analysis of ambulatory blood pressure monitoring (ABPM) recordings showed that median daytime diastolic BP load were significantly higher in diabetic patients compared to controls [12.35 (4.23-27.23) vs. 2.5 (0-8.7), p = 0.007]. Patients with elevated daytime systolic and diastolic BP loads had significantly higher BNP values compared to patients with normal BP load (31.4 ± 24.36 vs. 11.84 ± 11.25 pg/mL, p = 0.03 and 23.21 ± 15.12 vs. 12.12 ± 14.65 pg/mL, p = 0.03, respectively). Isovolemic contraction time (47.43 ± 7.84 vs. 42.27 ± 7.47, p = 0.045), isovolemic relaxation time (68.84 ± 10.43 vs. 58.77 ± 10.02, p = 0.02), and myocardial performance index (0.45 ± 0.10 vs. 0.37 ± 0.09, p = 0.02) as determined by tissue Doppler echocardiography were significantly high in diabetic patients compared to that of control cases. Ratio of mitral peak early diastolic flow velocity (E) to peak early diastolic myocardial velocities by tissue Doppler echocardiography (E') was also higher in patients with elevated daytime systolic BP load (E/E', 6.71 ± 1.97 vs. 4.91 ± 1.02, p = 0.04). CONCLUSION: Elevated BP loads detected by 24-h ambulatory BP measurements in children with type 1 diabetes are associated with increased BNP levels and abnormal tissue Doppler echocardiography indices, indicating early stage cardiac dysfunction.
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Kır et al. (2014) conducted an observational in Type 1 diabetes mellitus (n=50). Type 1 diabetes mellitus vs. Healthy children was evaluated on Median daytime diastolic BP load (p=0.007). Children with type 1 diabetes had higher median daytime diastolic BP loads than controls (12.35 vs 2.5, p=0.007), which correlated with increased BNP and abnormal tissue Doppler indices.
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