Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi

Year 2020, , 23 - 26, 15.01.2020

Nilüfer Çetiner , Semih Bolu , Habip Almış , Fatih İşleyen , Mehmet Turgut

https://doi.org/10.16948/zktipb.631740

Abstract

Amaç: Kardiyak
disfonksiyonun tip 1 diyabetin ciddi ve sık görülen komplikasyonlarından biri
olduğu bilinmektedir. Bu çalışmanın amacı, tip 1 diyabet tanılı çocuk ve
adolesanların kardiyak etkilenmenin konvansiyonel ekokardiyografi ile erken
dönemde değerlendirilmesiydi.

Gereç ve Yöntem: Çalışmada
53 tip 1 Diyabet tanılı çocuk ve adolesan ile benzer yaş ve cinsiyette 55
sağlıklı çocuk ve adolesan yer almaktadır. Katılımcıların, boy, kilo, vücut
kitle indeksi ve kan basıncı değerleri kaydedildi. Tip 1 diyabetli hasta
grubunda glisemik kontrol için glikolize hemoglobin ölçümü yapıldı. Tüm
katılımcıların miyokardiyal sistolik ve diyastolik  fonksiyonları 
konvansiyonel ekokardiyografi yöntemi ile değerlendirildi.

Bulgular: Tip 1
diyabetli 53 hastada kontrol grubuna göre triküspid kapağın A dalga akım hızı
anlamlı yüksek (p=0,04) ve triküspid E/A oranı ise anlamlı düşük  (p=0,02) bulundu. Sol ventrikül fraksiyonel
kısalma ve ejeksiyon fraksiyonu hasta grubunda kontrole göre daha düşük
bulundu, ancak istatiksel olarak anlamlı değildi (p değerleri sırasıyla 0,675,
0,933). Hasta grubunda glikolize hemoglobin düzeyi ile sol ventrikül sistolik
fonksiyonu arasında ise istatiksel olarak anlamlı negatif korelasyon bulundu
(p= 0,049, r= -0,669).

Sonuç: Tip 1 diyabet
tanısı olan çocuk ve adolesanlarda erken dönemde bile ekokardiyografik olarak sağ
ventrikülde diyastolik disfonksiyon ve glikolize hemoglobin  düzeyi ile sol ventrikül ejeksiyon fraksiyonu
arasında negatif korelasyonun gösterilmesi, kötü glisemik kontrollü diyabetik hastaların
peryodik olarak kardiyak değerlendirmelerinin noninvazif tanı yöntemi olan
ekokardiyografi ile yapılmasının gerekli olduğunu düşündürmektedir

Keywords

adolesan, çocuk, ekokardiyografi, kardiyak disfonksiyon, tip1diyabet

Early Evaluation of Cardiac Functions by Conventional Echocardiography in Children and Adolescents with Type 1 Diabetes

Abstract

Objective: It is known that cardiac dysfunction
is one of the serious and common complications of type 1 diabetes. The aim of
this study was to evaluation early cardiac functions of  children and adolescents with type 1 diabetes
by conventional echocardiography.

Material and Method:
This study included 53 children and adolescents with type 1 diabetes and 55
age-sex matched healty children and adolescents. The values of  height, weight, body-mass index and blood
pressure of the all participants were recorded. Glycated hemoglobin measuring
was performed for glycemic control in patients with type 1 diabetes. Myocardial
systolic and diastolic functions of all paticipants were assessed by
conventional echocardiography.

Results: A wave
velocity of tricuspid valve was significantly higher (p=0,04) and tricuspid E/A
rate was significantly less (p=0,02) in  patients with type 1 diabetes than controls. Fractional
shortening and ejection fraction of left ventricular revealed less in the
patient groups than controls, but  they
were no statistically significant differences (p values 0,675,0,933
respectively). Statistically significant negative correlation was noted between
level of glycated hemoglobin and ejection fraction of left ventricular in
patients group (p=0,049, r= -0,669).

Conclusion: Determination
of  right ventricular diastolic
dysfunction and negative corrrelation between 
level of glycated hemoglobin and left ventricular ejection fraction in
children and adolescents with type 1 diabetes suggest, that cardiac evaluation
of poor glycemic controlled diabetic patients is necessary periodically
performing by echocardiography, which  is
 noninvasive diagnostic method.

Keywords

Adolescent, Child, Echocardiography, Cardiac Dysfunction, Type 1 Diabetes

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