Progeria of the Heart in Type 1 Diabetic Children?

Journal of cardiovascular ultrasound Pub Date : 2017-03-01 Epub Date: 2017-03-27 DOI:10.4250/jcu.2017.25.1.1
Chi Young Shim
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Abstract

Diabetes mellitus (DM) itself may induce subclinical myocardial dysfunction without significant coronary artery disease. Accordingly, adults with type 2 DM are susceptible for heart failure and a lot of experimental studies have shown significant changes in microvasculature and myocardial interstitial fibrosis in type 2 DM. Therefore, early recognition of subclinical myocardial dysfunction and therapeutic intervention such as renin-angiotensin-aldosterone system blockers may prevent the progression of heart failure in diabetic patients. Although there have been many studies regarding diabetic cardiomyopathy in adults with type 2 DM, adults subjects innately have confounding factors for subclinical myocardial dysfunction. Aging, coronary artery disease, hypertension and long-standing metabolic properties related to insulin resistance also influence on left ventricular (LV) mechanical function. In this issue of the Journal, Abd-El Aziz et al. report the results of their study of forty patients with type 1 DM and fortytwo healthy controls between 6 and 16 years. In this study, the interrogators demonstrated that diabetic children have evidence of LV and right ventricular dysfunction on tissue Doppler echocardiographic assessment. Children with type 1 DM usually have fewer confounders of myocardial dysfunction than adults with type 2 DM. In fact, only one patient in this study subjects had blood pressure above 95th percentile. We can simply accept that myocardial dysfunction in diabetic children is mainly caused by DM itself. This is one of the strengths of this study. However, in the interpretation of the present study, main results should be cautiously understood. First, in terms of LV diastolic function, E’ velocity and E/E’ were not different between diabetic children and controls. The majority of differences regarding LV diastolic function between two groups were resulted from the mitral inflow Doppler parameters, which are depISSN 1975-4612 / eISSN 2005-9655 Copyright © 2017 Korean Society of Echocardiography www.kse-jcu.org https://doi.org/10.4250/jcu.2017.25.1.1
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1型糖尿病儿童心脏早衰症?
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