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. 2019 May-Jun;71(3):249-255.
doi: 10.1016/j.ihj.2019.04.008. Epub 2019 May 2.

Impairment of left and right ventricular longitudinal strain in asymptomatic children with type 1 diabetes

Ihsen Zairi  1 , Khadija Mzoughi  2 , Sofien Kamoun  3 , Fethia Ben Moussa  4 , Rabie Rezgallah  5 , Jihen Maatoug  6 , Sonia Mazigh  7 , Sondos Kraiem  8
Affiliations

Impairment of left and right ventricular longitudinal strain in asymptomatic children with type 1 diabetes

Ihsen Zairi et al. Indian Heart J. 2019 May-Jun.

Abstract

Aim: The relationship between type 1 diabetes (T1DM) and cardiac function in children is not well established. The purpose of this study was to investigate whether children and adolescents with T1DM present early asymptomatic abnormalities of left ventricular (LV) and right ventricular (RV) function. In addition, we evaluated the relationship of any such abnormalities with glycemic control and diabetes duration.

Methods: This was a prospective study. Standard echocardiography, tissue Doppler imaging, and two-dimensional strain analysis were performed prospectively in 52 children with T1DM. The results were compared with those from 52 healthy children matched for age and sex.

Results: There were no significant differences between the two groups in LV ejection fraction or RV systolic function. There was a difference between the two study groups in transtricuspid flow: the E-wave and A-wave velocities were significantly higher in the diabetic group. Left ventricular global longitudinal strain (LV GLS) was significantly lower in children with T1DM (-20.01 ± 1.86% vs. -22.99 ± 0.98%, respectively; P < .001), as was RV free-wall longitudinal strain (RV FWLS) (-29.13 ± 1.85% vs. -30.22 ± 1.53%, respectively; P = .002). LV GLS was correlated with diabetes duration (r = 0.444, P < .001) and glycated hemoglobin (HbA1c) (r = 0.683, P < .001); however, no correlation was found between RV FWLS and HbA1c or diabetes duration.

Conclusions: Our findings suggest that LV GLS and RV FWLS are impaired in children with T1DM and that the decrease in LV GLS is correlated with diabetes duration and HbA1c levels.

Keywords: 2D Echocardiography; Diabetes mellitus; Left ventricular function; Right ventricular function; Strain.

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Figures

Fig. 1
Fig. 1
Bull's-eye plot of LV GLS from a normal control (A) and patient with diabetes (B). Right ventricular free-wall global longitudinal strain (RV FWLS) from a normal control (C) and patient with diabetes (D). LV GLS: left ventricular global longitudinal strain.
Fig. 2
Fig. 2
Relationship between global longitudinal strain (%; GLS) and mean hemoglobin (%; HbA1c).
Fig. 3
Fig. 3
Relationship between global longitudinal strain (%; GLS) and duration of diabetes.
See this image and copyright information in PMC

References

    1. Laing S.P., Swerdlow A.J., Slater S.D. The British Diabetic Association Cohort Study, I: all-cause mortality in patients with insulin-treated diabetes mellitus. Diabet Med. 1999;16:459–465. - PubMed
    1. Lind M., Bounias I., Olsson M., Gudbjörnsdottir S., Svensson A.M., Rosengren A. Glycaemic control and incidence of heart failure in 20,985 patients with type 1 diabetes: an observational study. Lancet. 2011;378:140–146. - PubMed
    1. Labombarda F., Leport M., Morello R. Longitudinal left ventricular strain impairment in type 1 diabetes children and adolescents: a 2D speckle strain imaging study. Diabetes Metab. 2014;40:292–298. - PubMed
    1. Møller J.E., Poulsen S.H., Egstrup K. Effect of preload alternations on a new Doppler echocardiographic index of combined systolic and diastolic performance. J Am Soc Echocardiogr. 1999;12:1065–1072. - PubMed
    1. Widya R.L., van der Meer R.W., Smit J.W. Right ventricular involvement in diabetic cardiomyopathy. Diabetes Care. 2013;36:457–462. - PMC - PubMed

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