Evaluation of the left ventricular systolic function and myocardial deformation by real-time three-dimensional (four-dimensional) and speckle-tracking echocardiography in children with type 1 diabetes mellitus

• Published in: Cardiology in the young 2023-04, Vol.33 (4), p.603-607
• Main Authors: Eroğlu, Ayşe G., Yüksel, Esra K., Karagözlü, Fatih, Acar, Hazal C., Gökalp, Selman, Evliyaoğlu, Olcay
• Format: Article
• Language: English
• Subjects: Age; Asymptomatic; Body mass index; Body measurements; Child; Children; Circumferences; Correlation analysis; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Doppler effect; Echocardiography; Echocardiography - methods; Echocardiography and Scans; Echocardiography, Three-Dimensional - methods; Ejection fraction; Evaluation; Female; Heart; Hemoglobin; Humans; Hypertension; Laboratories; Laboratory tests; Male; Medical imaging; Mortality; Original Article; Patients; Real time; Reproducibility; Standard deviation; Statistical analysis; Stroke Volume; Tissues; Tracking; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Function, Left
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951122001408

This study aimed to evaluate the role of real-time three-dimensional (known as four-dimensional) echocardiography and three-dimensional speckle-tracking echocardiography for the early detection of left ventricular systolic dysfunction in asymptomatic children with type 1 diabetes mellitus. This cross-sectional study included 38 patients (mean age 15.4 ± 2.9, 42.1% male) and 38 age, gender, and body measurements matched healthy children. Each patient underwent an interview about medical history, a detailed clinical examination, blood laboratory tests, conventional echocardiography, and tissue Doppler imaging. Left ventricular ejection fraction; global longitudinal, circumferential, radial strain; twist; and torsion were measured by real-time three-dimensional and speckle-tracking echocardiography. Conventional echocardiography and tissue Doppler imaging showed normal left ventricular systolic function in the patients. Although left ventricular ejection fraction (61.6 ± 1.4%, 61.8 ± 1.1%, p = 0.386), global longitudinal [-26.6 (-27.7 to -26.1)%, -26.2 (-27.7 to -24.9)%, p = 0.224], and radial strain [44.4 (42.4-45.9)%, 43.9 (41-46.1)%, p = 0.513] were similar to the controls, circumferential strain (-27.3 ± 1.3%, -28.0 ± 1.6%, p = 0.048) and twist (9.5 ± 2.3°, 11.4 ± 3.0°, p = 0.003) were decreased in the patients compared with controls. We found that even in children with asymptomatic type 1 diabetes mellitus with normal left ventricular ejection fraction, circumferential function was impaired and rotation pattern was changed. This novel echocardiographic method might be an important tool for detecting left ventricular systolic dysfunction in type 1 diabetes mellitus children before it becomes overt on conventional echocardiography and tissue Doppler imaging.