Left atrial dysfunction and stiffness in pediatric and adult patients with Type 1 diabetes mellitus assessed with speckle tracking echocardiography
Left atrial dysfunction and stiffness in pediatric and adult patients with Type 1 diabetes mellitus assessed with speckle tracking echocardiography
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DOI：
10.1111/pedi.13141
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发表时间：
2020-11-21
影响因子：
3.4
通讯作者：
Shimizu, Toshiaki
中科院分区：
文献类型：
--
作者：
Ifuku, Mayumi;Takahashi, Ken;Shimizu, Toshiaki
背景1型糖尿病（T1 DM）患者由于糖尿病心肌病引起的心肌损伤导致亚临床舒张功能障碍，导致死亡和心力衰竭的风险很高。这种心肌损伤不仅延伸到左心室（LV），而且延伸到左心房（LA）。然而，儿童和年轻成人T1 DM患者的LA功能尚未得到广泛研究。目的因此，本研究的目的是使用超声心动图LA应变分析评估儿童和成人T1 DM患者的LA功能障碍。年龄（中位数：23 [范围：5-41]岁）T1 DM患者（D1：5-14岁，D2：15-24岁，D3：25-41岁）; 53名年龄和性别匹配的对照被分为三个相应的组（C1，C2和C3）。结果D2、D3组左房储层应变低于C2、C3组（P = 0.001、P = 0.004）; D2组的LA导管应变低于C2组（P = 0.002）。结论T1 DM患者中，青少年和青年组LA时相功能降低，>30岁组LA时相功能增加。左心房相位功能和左心房僵硬度可作为舒张功能障碍的早期标志物。
Background Subclinical diastolic dysfunction in patients with Type 1 diabetes mellitus (T1DM) caused by myocardial injury due to diabetic cardiomyopathy leads to a high risk of death and heart failure. This myocardial injury extends not only to the left ventricle (LV) but also to the left atrium (LA). However, LA function in children and young adults with T1DM has not been extensively studied.Objective Therefore, the aim of this study was to assess LA dysfunction in pediatric and adult patients with T1DM using LA strain analysis with echocardiography.Subjects Fifty-three patients (median age: 23 [range: 5-41] years) with T1DM.Methods We divided the patients into three age groups (D1: 5-14 years, D2: 15-24 years, D3: 25-41 years); 53 age- and sex-matched controls were divided into three corresponding groups (C1, C2, and C3). LA and LV functions were evaluated using echocardiography.Results LA reservoir strain was lower in the D2 and D3 groups than in the C2 and C3 groups (P = 0.001, P = 0.004, respectively). LA conduit strain was lower in the D2 group than in the C2 group (P = 0.002). LA stiffness was significantly greater in the D3 group than in the C3 group (P < 0.001).Conclusions In patients with T1DM, LA phasic function decreased in adolescents and young adults, and LA stiffness increased in adult patients aged >30 years. LA phasic function and LA stiffness can be potentially used as early markers for diastolic dysfunction.