Doppler tissue imaging and myocardial performance index of right ventricle in children with type I Diabetes mellitus

  • Deniz Oguz, Gazi University Medical Faculty Pediatric Cardiology Department, Turkey
  • Sedef Tunaoglu, Gazi University Medical Faculty Pediatric Cardiology Department, Turkey
  • Rana Olgunturk, Gazi University Medical Faculty Pediatric Cardiology Department, Turkey
  • A/Prof Serdar Kula, Gazi University Medical Faculty Pediatric Cardiology Department, Turkey
  • Oya Balci, Gazi University Medical Faculty Pediatric Cardiology Department, Turkey

    • Introduction:
    Diabetes Mellitus (DM) Type I is a chronic autoimmune disorder. We aimed to determine the annular Doppler tissue imaging (DTI) and myocardial performance index (MPI) of children with DM.
    Methods:
    18 patients and 16 healthy children as control group were enrolled in the study. All children had chest x-ray and ECG. DTI was measured at the mitral and tricuspid annulus and systolic wave (S), early diastolic wave (E’) and late diastolic wave (A’) were determined. MPI was calculated by DTI.
    Results:
    The mean age was 14,78±3,73 and 9,01±3,38 years in the patient and control group respectively. All children were asymptomatic with normal physical examination, chest-ray and ECG findings. Duration of the disease was 1,5-15 years (median: 4 years) and HbA1C levels were 7,56±0,85. Right ventricle end diastolic diameter and vena cava inferior measurements were significantly higher in the DM group. Systolic functions of left ventricle (LV) showed no difference in both groups (EF:66,28+7,35 vs 66,50±6,57% and FS:36,28±6,30 vs 38,50+6,71).
    MPI measurements for LV were similar in both groups; 0,41±0,08 vs 0,43+0,09 in the diabetic and control group respectively.
    However MPI values for right ventricle were significantly higher in the patient group. (0,35+0,14 vs 0,26±0,09, p:0,034)
    Conclusion:
    Though LV functions in DM had been thoroughly studied, right ventricle had been neglected in the past. Abnormalities in microvascular circulation in the pulmonary capillary bed can explain our DTI and MPI results which shows that right heart should also be evaluated in DM patients.