Evaluation of Cardiac Dysfunction in Children and Adolescents with Type 1 Diabetes Mellitus

 This study was conducted to identify cardiac dysfunction and the relationship of hemoglobin A1c (HbA1c) levels and serum lipids to echocardiographic indices in children and adolescents with T1DM.

This  case-control study was conducted on  100 cases  including 50 children and adolescents aged 3-19 years old suffering T1DM for at least  two years and 50 age- and sex-matched healthy subjects with the patients. This study was conducted in Shahrekord, Iran. All participants underwent TDI echocardiography and the levels of HbA1C and serum lipid were measured in diabetic patients. Then echocardio function of two groups were compared and the relation between these findings and HbA1C and lipids was evaluated. Data was analyzed using SPSS software (version 23.0).

MPI, E/A, E'/A', E wave, A wave, IVRT, ET, EDV, LVIDd and LVIDs were significantly different between diabetes and control groups (P<0.05). However, EF, E/ E', IVCT, ESV and EF values showed no significant difference between diabetes and control groups (P>0.05). A significant, positive correlation was observed between E/E' and TG (p=0.007, r= 0.37). E/A showed positive correlation with HDL (p=0.046, r=0.284) and negative correlation with TG (p = 0.048, r=-0.281), and LDL (P=0.012, r=-0.352). E'/A' showed positive correlation with HDL (p=0.033, r=0.302), and negative correlation with TG (p=0.014, r=-0.347) in diabetic patients.

In diabetic patients, first, cardiac diastolic function decreases, resulting in a decrease in E¢/A and E/A ratios as well as a decrease in myocardial performance index, which indicates systolic and diastolic function, and is recommended to be taken into account in the initial examination of the heart of diabetics and not to wait for late-onset systolic function change.