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

Yıl 2020, , 23 - 26, 15.01.2020
https://doi.org/10.16948/zktipb.631740

Öz

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

Kaynakça

  • 1. International Diabetes Federation. IDF Diabetes Atlas, 5th ed. Brussels: International Diabetes Federation; 2011.
  • 2. Hill MF. Diabetic cardiomyopathy: Cardiac changes. Pathophysiological mechanisms. Biologic markers and the available therapeutic armamentarium. In: Cardiomyopathies – from basic research to clinical management. Veselka J (Ed) 2012:487–512.
  • 3. Feuvray D. Cardiac metabolism in the diabetic patient. Heart Metab. 2010;46:11–5.
  • 4. Kiencke S, Handschin R, von Dahlen R, Muser J, Brunner-LaRocca HP, Schumann J, et al. Pre-clinical diabetic cardiomyopathy: prevalence, screening, and outcome. Eur J Heart Fail. 2010;12(9):951–7.
  • 5. From AM, Scott CG, Chen HH. The development of heart failure in patients with diabetes mellitus and pre-clinical diastolic dysfunction a populationbased study. J Am Coll Cardiol. 2010;55(4):300–5.
  • 6. Jensen MT, Sogaard P, Andersen HU, Bech J, Hansen TF, Biering Soerensen T, et al. Prevalence of systolic and diastolic dysfunction in patients with type 1 diabetes without known heart disease: the Thousand & 1 Study. Diabetologia. 2014;57(4):672–80.
  • 7. Karamitsos TD, Karvounis HI, Dalamanga EG, Papadopoulos CE, Didangellos TP, Karamitsos DT, et al. Early diastolic impairment of diabetic heart: The significance of right ventricle. Int J Cardiol. 2007;114(2):218–23.
  • 8. Vazeou A, Papadopoulou A, Miha M. Cardiovascular impairment in children, adolescents, and young adults with type 1 diabetes mellitus (T1DM). Eur J Pediatr. 2008;167:877–84.
  • 9. Kim EH, Kim YH. Left ventricular function in children and adolescents with type 1 diabetes mellitus. Korean Circ J 2010;40(3):125-30.
  • 10. Elshahed GS, Ahmed MI, El-Beblawy NS, Kamal HM, Ismaiel MF, Bin Zheidan OAS. Evaluation of right and left ventricular systolic and diastolic function in patients with type 1 diabetes using echocardiography and tissue Doppler imaging. Suez Canal Univ Med J 2008;11:65-74.
  • 11. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al: Recommendations for chamber quantification: A report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18(12):1440–63.
  • 12. Voulgari C, Papadogiannis D, Tentolouris N. Diabetic cardiomyopathy: from the pathophysiology of the cardiac myocytes to current diagnosis and management strategies. Vasc Health Risk Manag 2010;6:883-903.
  • 13. Khattab AA, Soliman MA: Biventricular function and glycemic load in type 1 diabetic children: Doppler tissue-imaging study. Pediatr Cardiol 2015;36:423–31.14. Asghar O, Al-Sunni A, Khavandi K, et al: Diabetic cardiomyopathy. Clin Sci (Lond) 2009;116(10):741–60.
  • 15. Brunvand L, Fugelseth D, Stensaeth KH, Dahl-Jørgensen K, Margeirsdottir HD. Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study. BMC Cardiovasc Disord.2016; (25);16:103.
  • 16. Suys BE, Katier N, Rooman RP, Matthys D, Op De Beeck L, Du Caju MV, et al. Female children and adolescents with type 1 diabetes have more pronounced early echocardiographic signs of diabetic cardiomyopathy. Diabetes Care. 2004;27(8):1947–53.
  • 17. Aepfelbacher FC, Yeon SB, Weinrauch LA, D’Elia J, Burger AJ. Improved glycemic control induces regression of left ventricular mass in patients with type 1 diabetes mellitus. Int J Cardiol. 2004;94:47–51.
  • 18. Shivalkar B, Dhondt D, Gaal LV, Bartunek J, Crombrugge PV, Vrints C. Flow mediated dilatation and cardiac function in type 1 diabetes mellitus. Am J Cardiol. 2006;97(1):77–82.
  • 19. Abd EI, Dayem SM, Battah AA. Effect of glycaemic control on the progress of left ventricular hypertrophy and diastolic dysfunction in children with type 1 diabetes mellitus. Anadolu Kardiyol Derg. 2012;12:498–507.
  • 20. Van Heerebeek L, Hamdani N, Handoko ML, Falcao-Pires I, Musters RJ, Kupreishvili K, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation. 2008;117(1):43–51.
  • 21. Yoldaş T, Örün UA, Sagsak E, Aycan Z, Kaya Ö, Özgür S, Karademir S. Subclinical left ventricular systolic and diastolic dysfunction in type 1 diabetic children and adolescents with good metabolic control. Echocardiography. 2018 Feb;35(2):227-33.
  • 22. Nakai H, Takeuchi M, Nishikage T, Lang RM, Otsuji Y: Subclinical left ventricular dysfunction in asymptomatic diabetic patients assessed by two-dimensional speckle tracking echocardiography: Correlation with diabetic duration. Eur J Echocardiogr 2009;10(8):926- 32.
  • 23. Sanderson JE, Fraser AG: Systolic dysfunction in heart failure with a normal ejection fraction: Echo-Doppler measurements. Prog Cardiovasc Dis 2006;49(3):196–206.
  • 24. Altun G, Babaoğlu K, Binnetoğlu K, Özsu E, Yeşiltepe Mutlu RG, Hatun Ş. Subclinical Left Ventricular Longitudinal and Radial Systolic Dysfunction in Children and Adolescents with Type 1 Diabetes Mellitus. Echocardiography. 2016 Jul;33(7):1032-39.

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

Yıl 2020, , 23 - 26, 15.01.2020
https://doi.org/10.16948/zktipb.631740

Öz

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.

Kaynakça

  • 1. International Diabetes Federation. IDF Diabetes Atlas, 5th ed. Brussels: International Diabetes Federation; 2011.
  • 2. Hill MF. Diabetic cardiomyopathy: Cardiac changes. Pathophysiological mechanisms. Biologic markers and the available therapeutic armamentarium. In: Cardiomyopathies – from basic research to clinical management. Veselka J (Ed) 2012:487–512.
  • 3. Feuvray D. Cardiac metabolism in the diabetic patient. Heart Metab. 2010;46:11–5.
  • 4. Kiencke S, Handschin R, von Dahlen R, Muser J, Brunner-LaRocca HP, Schumann J, et al. Pre-clinical diabetic cardiomyopathy: prevalence, screening, and outcome. Eur J Heart Fail. 2010;12(9):951–7.
  • 5. From AM, Scott CG, Chen HH. The development of heart failure in patients with diabetes mellitus and pre-clinical diastolic dysfunction a populationbased study. J Am Coll Cardiol. 2010;55(4):300–5.
  • 6. Jensen MT, Sogaard P, Andersen HU, Bech J, Hansen TF, Biering Soerensen T, et al. Prevalence of systolic and diastolic dysfunction in patients with type 1 diabetes without known heart disease: the Thousand & 1 Study. Diabetologia. 2014;57(4):672–80.
  • 7. Karamitsos TD, Karvounis HI, Dalamanga EG, Papadopoulos CE, Didangellos TP, Karamitsos DT, et al. Early diastolic impairment of diabetic heart: The significance of right ventricle. Int J Cardiol. 2007;114(2):218–23.
  • 8. Vazeou A, Papadopoulou A, Miha M. Cardiovascular impairment in children, adolescents, and young adults with type 1 diabetes mellitus (T1DM). Eur J Pediatr. 2008;167:877–84.
  • 9. Kim EH, Kim YH. Left ventricular function in children and adolescents with type 1 diabetes mellitus. Korean Circ J 2010;40(3):125-30.
  • 10. Elshahed GS, Ahmed MI, El-Beblawy NS, Kamal HM, Ismaiel MF, Bin Zheidan OAS. Evaluation of right and left ventricular systolic and diastolic function in patients with type 1 diabetes using echocardiography and tissue Doppler imaging. Suez Canal Univ Med J 2008;11:65-74.
  • 11. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al: Recommendations for chamber quantification: A report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18(12):1440–63.
  • 12. Voulgari C, Papadogiannis D, Tentolouris N. Diabetic cardiomyopathy: from the pathophysiology of the cardiac myocytes to current diagnosis and management strategies. Vasc Health Risk Manag 2010;6:883-903.
  • 13. Khattab AA, Soliman MA: Biventricular function and glycemic load in type 1 diabetic children: Doppler tissue-imaging study. Pediatr Cardiol 2015;36:423–31.14. Asghar O, Al-Sunni A, Khavandi K, et al: Diabetic cardiomyopathy. Clin Sci (Lond) 2009;116(10):741–60.
  • 15. Brunvand L, Fugelseth D, Stensaeth KH, Dahl-Jørgensen K, Margeirsdottir HD. Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study. BMC Cardiovasc Disord.2016; (25);16:103.
  • 16. Suys BE, Katier N, Rooman RP, Matthys D, Op De Beeck L, Du Caju MV, et al. Female children and adolescents with type 1 diabetes have more pronounced early echocardiographic signs of diabetic cardiomyopathy. Diabetes Care. 2004;27(8):1947–53.
  • 17. Aepfelbacher FC, Yeon SB, Weinrauch LA, D’Elia J, Burger AJ. Improved glycemic control induces regression of left ventricular mass in patients with type 1 diabetes mellitus. Int J Cardiol. 2004;94:47–51.
  • 18. Shivalkar B, Dhondt D, Gaal LV, Bartunek J, Crombrugge PV, Vrints C. Flow mediated dilatation and cardiac function in type 1 diabetes mellitus. Am J Cardiol. 2006;97(1):77–82.
  • 19. Abd EI, Dayem SM, Battah AA. Effect of glycaemic control on the progress of left ventricular hypertrophy and diastolic dysfunction in children with type 1 diabetes mellitus. Anadolu Kardiyol Derg. 2012;12:498–507.
  • 20. Van Heerebeek L, Hamdani N, Handoko ML, Falcao-Pires I, Musters RJ, Kupreishvili K, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation. 2008;117(1):43–51.
  • 21. Yoldaş T, Örün UA, Sagsak E, Aycan Z, Kaya Ö, Özgür S, Karademir S. Subclinical left ventricular systolic and diastolic dysfunction in type 1 diabetic children and adolescents with good metabolic control. Echocardiography. 2018 Feb;35(2):227-33.
  • 22. Nakai H, Takeuchi M, Nishikage T, Lang RM, Otsuji Y: Subclinical left ventricular dysfunction in asymptomatic diabetic patients assessed by two-dimensional speckle tracking echocardiography: Correlation with diabetic duration. Eur J Echocardiogr 2009;10(8):926- 32.
  • 23. Sanderson JE, Fraser AG: Systolic dysfunction in heart failure with a normal ejection fraction: Echo-Doppler measurements. Prog Cardiovasc Dis 2006;49(3):196–206.
  • 24. Altun G, Babaoğlu K, Binnetoğlu K, Özsu E, Yeşiltepe Mutlu RG, Hatun Ş. Subclinical Left Ventricular Longitudinal and Radial Systolic Dysfunction in Children and Adolescents with Type 1 Diabetes Mellitus. Echocardiography. 2016 Jul;33(7):1032-39.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Nilüfer Çetiner 0000-0001-6827-5527

Semih Bolu 0000-0002-8183-2188

Habip Almış 0000-0001-9327-4876

Fatih İşleyen 0000-0002-5015-621X

Mehmet Turgut 0000-0002-2155-8113

Yayımlanma Tarihi 15 Ocak 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

APA Çetiner, N., Bolu, S., Almış, H., İşleyen, F., vd. (2020). Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi. Zeynep Kamil Tıp Bülteni, 51(1), 23-26. https://doi.org/10.16948/zktipb.631740
AMA Çetiner N, Bolu S, Almış H, İşleyen F, Turgut M. Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi. Zeynep Kamil Tıp Bülteni. Ocak 2020;51(1):23-26. doi:10.16948/zktipb.631740
Chicago Çetiner, Nilüfer, Semih Bolu, Habip Almış, Fatih İşleyen, ve Mehmet Turgut. “Tip 1 Diyabetli Çocuk Ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi Ile Erken Dönem Değerlendirilmesi”. Zeynep Kamil Tıp Bülteni 51, sy. 1 (Ocak 2020): 23-26. https://doi.org/10.16948/zktipb.631740.
EndNote Çetiner N, Bolu S, Almış H, İşleyen F, Turgut M (01 Ocak 2020) Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi. Zeynep Kamil Tıp Bülteni 51 1 23–26.
IEEE N. Çetiner, S. Bolu, H. Almış, F. İşleyen, ve M. Turgut, “Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi”, Zeynep Kamil Tıp Bülteni, c. 51, sy. 1, ss. 23–26, 2020, doi: 10.16948/zktipb.631740.
ISNAD Çetiner, Nilüfer vd. “Tip 1 Diyabetli Çocuk Ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi Ile Erken Dönem Değerlendirilmesi”. Zeynep Kamil Tıp Bülteni 51/1 (Ocak 2020), 23-26. https://doi.org/10.16948/zktipb.631740.
JAMA Çetiner N, Bolu S, Almış H, İşleyen F, Turgut M. Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi. Zeynep Kamil Tıp Bülteni. 2020;51:23–26.
MLA Çetiner, Nilüfer vd. “Tip 1 Diyabetli Çocuk Ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi Ile Erken Dönem Değerlendirilmesi”. Zeynep Kamil Tıp Bülteni, c. 51, sy. 1, 2020, ss. 23-26, doi:10.16948/zktipb.631740.
Vancouver Çetiner N, Bolu S, Almış H, İşleyen F, Turgut M. Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi. Zeynep Kamil Tıp Bülteni. 2020;51(1):23-6.