scholarly journals The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus

2011 ◽  
Vol 14 (2) ◽  
pp. 49-52
Author(s):  
Irina Arkad'evna Bondar' ◽  
Elena Anatol'evna Koroleva ◽  
Olga Grigor'evna Chudinova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Myocardial Remodeling ◽  
Left Ventricular Myocardial Mass

Aim. To assess the influence of diabetic autonomous neuropathy (DAN) on left ventricular myocardial remodeling in type 1 diabetes mellitus. Materials and methods. The study included 78 patients (30 men and 48 women) with DM1 (mean age 28.9?8.3 years, DM1 duration9.7?7.5 years). DAN was diagnosed by standard ECG tests (Valsalva and breathing tests). The patients were examined using echocardiographywith the measurement of the thickness of interventricular septum (IVS) and left ventricle posterior wall (PW), end diastolic and systolic size (EDS and ESS) of the left ventricle, left ventricular myocardial mass (MM), MM index and relative wall thickness (RWT). LV hypertrophy(LVH) was diagnosed at MM index ?134 g/m2 in men and ?110 g/m2 in women; concentric and excentric types of LV hypertrophy wererecorded at RWT ?0.45 and

scholarly journals Correlation between echocardiographic parameters of left ventricle and glycosylated hemoglobin in children with type 1 Diabetes Mellitus

2022 ◽  
Vol 3 (1) ◽  
pp. 44-52
Author(s):  
Valeriu ESANU ◽  
Ina PALII
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Wall Thickness ◽  
Structural Parameters ◽  
Glycosylated Hemoglobin ◽  
Left Ventricular ◽  
Systolic Volume

Introduction. Deterioration of left ventricular (LV) parameters in Diabetes Mellitus (DM) can occur in the absence of other heart problems. An association between glycosylated hemoglobin (HbA1c) and changes of the LV parameters in DM has been reported. However, data regarding this association model in children with Type 1 Diabetes Mellitus (T1DM) are limited. The purpose of the work was to investigate the association between HbA1c and the LV parameters in pediatric patients. Material and methods. The study was conducted on 28 children with T1DM ((aged 10 - 18 years, gender M (15)/F (13), duration ≥5 years). The clinical (standard medical examination) and paraclinical (biochemical dosage – HbA1c, echocardiography – LV functional and structural parameters) data was carried out. Statistical analysis  used the SPSS version 20. Results. The correlational study between the HbA1c and the LV parameters revealed a statistically significant positive correlation coefficient with aortic root diameter (mm) (r=0.7**, p<0.001), left atrium (mm) (r=0.8**, p<0.001 LV diastolic diameter (mm) (r=0.7**, p<0.001), LV systolic diameter (mm) (r=0.7**, p<0.001), septal wall thickness (mm) (r=0.5*, p=0.036), posterior wall thickness (mm) (r=0.5*, p=0.032), LV diastolic volume (ml) (r=0.5*, p=0.025), LV systolic volume (ml) (r=0.6**, p=0.01), ejection fraction (%) (r=0.7**, p=0.001), fractional shortening (%) (r=0.6**, p=0.002). Conclusions. The results of the study show that in children with T1DM, the increase value of the HbA1c is associated with a consensual and proportional increase in the values of the parameters of the left ventricle.  

scholarly journals Assessment of the functional state of the heart in children born to mothers with type I diabetes mellitus

2021 ◽  
Vol 18 (3) ◽  
pp. 263-273
Author(s):  
A. V. Sukalo ◽  
V. A. Prylutskaya ◽  
E. V. Ivanova ◽  
T. A. Dzerkach
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Cardiac Function ◽  
Glycated Hemoglobin ◽  
Myocardial Hypertrophy ◽  
Heart Defects ◽  
Interventricular Septum ◽  
Posterior Wall

Maternal diabetes mellitus (DM) is a chronic disease that carries significant risks for the fetus and newborn. Hyperglycemia during pregnancy contributes to the development of structural heart defects, myocardial hypertrophy, and impaired cardiac function in newborns. The objective of the study was to evaluate the echocardiographic parameters of the cardiac function in children born to mothers with type 1 diabetes mellitus (DM1).A prospective study of 163 newborns was conducted on the basis of the Republican Scientific and Practical Center “Mother and Child”. The children were divided into 2 groups. The main group consisted of 107 children born to mothers with DM1 (Gr1), the control group – 56 healthy infants born to women with normoglycemia during pregnancy (Gr2).It was found that a newborn in Gr1 has a larger thickness of the interventricular septum (IVS) (p < 0.001), the posterior wall of the left ventricle (p < 0.001), and the size of the right ventricle (p < 0.001). It was revealed that in Gr1 the frequency of myocardial hypertrophy with an interventricular septum thickness of 5 mm or more is 30.8 %, which is statistically significantly higher in comparison with Gr2 (1.8 %, F = 0.115, p < 0.001). When assessing the blood flow using a pulse-wave Doppler study, the manifestations of the diastolic dysfunction in Gr1 were revealed. The E/A ratio for the   flow through the mitral valve in Gr1 was 0.9 (0.8–1.1), in Gr2 – 1.2 (1.0–1.4), p = 0.043. The study confirmed a lower frequency of registration of myocardial hypertrophy with good glycemic control during pregnancy (p < 0.05). Direct correlations between the average level of glycated hemoglobin in mothers and the IVS thickness (r = 0.374, p < 0.05) and the posterior wall of the left ventricle (r = 0.293, p < 0.05) of their newborns were observed in infants in Gr1.The use of pump insulin therapy in pregnant women with type 1 diabetes allowed a statistically significant reduction in the frequency of hypertrophy of the left ventricle in infants in the neonatal period.Diabetes mellitus type 1 in the mother determines not only the risk of congenital heart defects, but also hypertrophic changes in the myocardium, contributes to the diastolic dysfunction in this group of children. The achievement of target levels of glycated hemoglobin during pregnancy, using pump insulin therapy, provides a lower frequency of registration of ventricular septal hypertrophy. The revealed statistically significant differences in the IVS thickness and the posterior wall of the left ventricle in infants born to mothers with type 1 diabetes should be taken into account by doctors in the system of organizing medical care in inpatient settings and at the stage of dispensary observation.

P620The prognostic value of the ratio of transmitral early filling velocity to early diastolic strain rate in type 1 diabetes patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M H Lassen ◽  
T B S Biering-Soerensen ◽  
P G J Joergensen ◽  
H U A Andersen ◽  
P R Rossing ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Morbidity And Mortality ◽  
Female Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Early Filling

Abstract Background Cardiovascular disease is one of the main causes of morbidity and mortality in patients suffering from type 1 diabetes mellitus. It is of great importance to identify early signs of cardiac pathology such as elevated left ventricular (LV) filling pressure. The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has in recent studies proved to be an accurate measure of left ventricular (LV) filling pressure. Furthermore, E/e'sr has demonstrated strong prognostic value across different study populations. Purpose The aim of this study was to assess the prognostic value of E/e'sr in a large cohort of patients with type 1 diabetes mellitus in relation to cardiovascular morbidity and mortality. Methods In this prospective study, 1082 patients with type 1 diabetes mellitus (mean age 50±15 years, 53% male, mean duration of diabetes 26 years) underwent a comprehensive echocardiographic examination including both conventional measurements and two-dimensional speckle tracking in which E/e'sr along with other echocardiographic measurements were obtained. The primary outcome was defined as a major cardiac event (heart failure, stroke, myocardial infarction or cardiovascular death). Results During follow-up (median: 6.2 years, IQR: 5.7, 6.9) 144 (13.3%) met the composite outcome. E/e'sr was significantly associated with the composite outcome (E/e'sr: HR 1.36 95% CI [1.25–1.47], p<0.001, per 0.10m increase) (figure). E/e'sr remained an independent predictor after multivariable adjustment for age, gender, duration of diabetes, BMI, HbA1c, smoking status, level of physical activity, systolic blood pressure, cholesterol level, eGFR, albuminuria, LV ejection fraction, LV dimensions and left atrial volume index (E/e'sr: HR 1.16 95% CI [1.04–1.28], p=0.006, per 0.10m increase). Interestingly, E/e'sr was especially good as a prognosticator in female patients (p for interaction = 0.008) in a univariable model: (female: HR 1.53 95% CI [1.37–1.71], p<0.001, per 0.10m increase) (male: HR 1.23 95% CI [1.10–1.38], p<0.001, per 0.10m increase). In the same multivariable model as before, E/e'sr remained an independent predictor of the outcome in female patients whereas the same was not true for male patients (female: HR 1.39 95% CI [1.18–1.66], p<0.001, per 0.10m increase) vs (male: HR 1.05 95% CI [0.92–1.21], p=0.46, per 0.10m increase). Conclusion In patients with type 1 diabetes, E/e'sr provides independent prognostic information regarding cardiovascular morbidity and mortality. Furthermore, E/e'sr seems to have stronger prognostic value in female patients with type 1 diabetes.

scholarly journals Abnormal left ventricular torsion and cardiac autonomic dysfunction in subjects with type 1 diabetes mellitus

Metabolism ◽  
2011 ◽  
Vol 60 (8) ◽  
pp. 1115-1121 ◽  
Author(s):  
Milan K. Piya ◽  
Ganesh Nallur Shivu ◽  
Abd Tahrani ◽  
Kiran Dubb ◽  
Khalid Abozguia ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Torsion ◽  
Cardiac Autonomic Dysfunction ◽  
Ventricular Torsion

scholarly journals Heart geometry in climacteric syndrome on the background of type 1 diabetes mellitus

2021 ◽  
Vol 17 (4) ◽  
pp. 304-307
Author(s):  
O.A. Goncharova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Postmenopausal Women ◽  
Wall Thickness ◽  
Estrogen Deficiency ◽  
The Body ◽  
Perimenopausal Women

Background. The climacteric period in women with type 1 diabetes mellitus (DM1) initiates an additional damaging effect on the existing cardinal pathology associated with DM. The purpose was to establish the features of geometric remodeling of the left ventricle (LV) of the heart in women with DM1 during the climacteric period. Materials and methods. The study involved 60 women with type 1 diabetes at the age of 48.74 ± 0.65 years, inclu­ding 41 perimenopausal and 19 postmenopausal ones. The control group consisted of 20 women without diabetes mellitus at the age of 50.02 ± 0.71 years. According to echocardiography, taking into account the stage of menopause, the indicators of the end-diastolic volume (EDV) and size (EDS), the posterior wall thickness of the LV (LVPWT) and the interventricular septum (IVST) were analyzed. The frequency of various types of geometric remodeling of the left ventricle of the heart was analyzed using the Penn Convention formula; for this, the LV myocardial mass index (LVMI) was calculated according to the formulas LVMI = 1.04 [(EDS + LVPWT + IVST)3 – EDS3] – 13.6 (LVMI = ratio LVMI to the plane of the body surface (A) in m2; AM2 = 1 + Weight + Δh / 100, where Δh is the difference between the height of a woman and 160 cm) and the relative wall thickness of the LV (LVRWT) LVRWT = 2LVPWT / EDS. Based on these data, the frequency of various types of geometric remodeling was established: normal geometry, concentric remode­ling, concentric or eccentric LV hypertrophy. Results. The data obtained indicate that postmenopausal women present a significant decrease in the frequency of normal heart geometry compared to perimenopausal women (26.4 versus 75.6 %, p < 0.001) and the frequency of concentric LV remodeling 3.5 times increases (26.3 versus 7.3 %, respectively). Concentric hypertrophy and eccentric LV hypertrophy prevailed 2.5 times in postmenopausal women (31.6 versus 12.1 % and 12.7 versus 4.9 %). Conclusions. In perimenopausal women with type 1 diabetes mellitus, in almost a quarter of cases, geometric remodeling of the left ventricle of the heart takes place. In postmenopausal women with estrogen deficiency, the frequency of pathologi­cal forms of heart geometry exceeds 75 %. The strategy of therapy for cardiac pathology in menopausal women against the background of DM1 should take into account the pathogenetic mechanisms of pathology associated with impaired carbohydrate metabolism and atherogenic measurements against the background of estrogen deficiency as well as limit polypharmacy.

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