TİP-1 DİABETES MELLİTUS TANILI ÇOCUKLARDA GLİSEMİK KONTROL DERECESİNE GÖRE SOL VENTRİKÜL FONKSİYONLARININ EKOKARDİYOGRAFİK OLARAK DEĞERLENDİRİLMESİ

Amaç: Çalışmanın amacı, Tip-1 Diabetes Mellitus (DM) tanılı çocuk ve adölesanlarda glisemik control derecesinin kardiyak fonksiyonlar üzerindeki etkilerinin araştırılmasıydı. Materyal ve Metot: Tip-1 DM tanılı çocuk ve adölesanlar glisemik kontrolüne göre; orta kontrollü (OK) ve kötü kontrollü (KK) hastalar olarak iki gruba ayrıldı. Hastalar sol ventrikül sistolik ve diyastolik fonksiyon açısından konvansiyonel, ‘pulsed’ Doppler ve doku Doppler görüntüleme (DDG) ekokardiyografik parametreleri kullanılarak değerlendirildi. Bulgular: Otuz çocuk hasta OK grubunda, otuz çocuk KK grubunda ve 30 çocuk kontrol grubundaydı. Diyabetik hastalar ile kontrol grupları arasında ‘pulsed’ ve doku Doppler ekokardiyografik parametreler açısından istatistiksel olarak anlamlı farklar gösterilmiştir. KK grubunda doku Doppler parametreleri izovolumetrik kontraksiyon, izovolumetrik relaksasyon zamanında istatistiksel anlamlı olarak uzama ve ejeksiyon zamanında ise anlamlı olarak kısalma gösterilmiştir ki sonuç olarak sol ventrikül fonksiyonları ile metabolik kontrol arasında anlamlı bir ilişki bulunmuştur. Sonuç: Tip-1 DM'li çocuklarda konvansiyonel ve doku Doppler ekokardiyografide sol ventrikül fonksiyonlarında bozukluk saptandı. Bu çalışma, sol ventrikül diyastolik fonksiyonlarındaki bozulmanın glisemik kontrol ile doğrudan ilişkili olabileceğini ve kötü derecede metabolik kontrolü olan çocuklarda diyabetik kardiyomiyopati riskinin daha yüksek olduğunu göstermiştir.

Echocardiographic Evaluation of Left Ventricular Functions According to the Degree of Glycemic Control in Children with Type-1 Diabetes Mellitus

Aim: The aim of the study was the evaluation of the effects of glycemic control on cardiac functions in children and adolescents diagnosed with Type-1 Diabetes Mellitus (DM). Materials and Methods: Children with Diabetes type-1 were divided into two groups as moderate-controlled (MC) and poorly-controlled (PC) patients according to the glycemic control. The patients were evaluated in terms of conventional, 'pulsed' Doppler and tissue Doppler imaging (DDG) echocardiographic parameters for left ventricular systolic and diastolic function. Results: Thirty children were in the MC group, thirty children in the PC group and 30 in the control group. There were statistically significant differences between diabetic patients and control groups in terms of 'pulsed' and tissue Doppler echocardiographic parameters. Tissue Doppler parameters in the PC group showed, statistically significant elongation time of isovolumetric relaxation, isovolumetric contraction and significantly shortening time of ejection, as a result, a significant relationship was found between the left ventricle functions and metabolic control. Conclusion: Conventional and tissue Doppler echocardiography showed dysfunction of left ventricular function in children with type-1 DM. This study found that impairment of left ventricular diastolic functions may be directly related to glycemic control, and children with poor metabolic control have a higher risk of diabetic cardiomyopathy.

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