Nilüfer ÇETİNER, Semih BOLU, Habip ALMIŞ, M. Fatih İŞLEYEN, Mehmet Turgut ADATEPE

Tip 1 Diyabetli Çocuk ve Adolesanlarda Kardiyak Fonksiyonların Konvansiyonel Ekokardiyografi ile Erken Dönem Değerlendirilmesi

Amaç: Kardiyak disfonksiyonun tip 1 diyabetin ciddi ve sık görülen komplikasyonlarından biri olduğu bilinmektedir. Bu çalışmanın amacı, tip 1 diyabet tanılı çocuk ve adolesanların kardiyak etkilenmenin konvansiyonel ekokardiyografi ile erken dönemde değerlendirilmesiydi.Gereç ve Yöntem: Çalışmada 53 tip 1 Diyabet tanılı çocuk ve adolesan ile benzer yaş ve cinsiyette 55 sağlıklı çocuk ve adolesan yer almaktadır. Katılımcıların, boy, kilo, vücut kitle indeksi ve kan basıncı değerleri kaydedildi. Tip 1 diyabetli hasta grubunda glisemik kontrol için glikolize hemoglobin ölçümü yapıldı. Tüm katılımcıların miyokardiyal sistolik ve diyastolik fonksiyonları konvansiyonel ekokardiyografi yöntemi ile değerlendirildi.Bulgular: Tip 1 diyabetli 53 hastada kontrol grubuna göre triküspid kapağın A dalga akım hızı anlamlı yüksek (p=0,04) ve triküspid E/A oranı ise anlamlı düşük (p=0,02) bulundu. Sol ventrikül fraksiyonel kısalma ve ejeksiyon fraksiyonu hasta grubunda kontrole göre daha düşük bulundu, ancak istatiksel olarak anlamlı değildi (p değerleri sırasıyla 0,675, 0,933). Hasta grubunda glikolize hemoglobin düzeyi ile sol ventrikül sistolik fonksiyonu arasında ise istatiksel olarak anlamlı negatif korelasyon bulundu (p= 0,049, r= -0,669). Sonuç: Tip 1 diyabet tanısı olan çocuk ve adolesanlarda erken dönemde bile ekokardiyografik olarak sağ ventrikülde diyastolik disfonksiyon ve glikolize hemoglobin düzeyi ile sol ventrikül ejeksiyon fraksiyonu arasında negatif korelasyonun gösterilmesi, kötü glisemik kontrollü diyabetik hastaların peryodik olarak kardiyak değerlendirmelerinin noninvazif tanı yöntemi olan ekokardiyografi ile yapılmasının gerekli olduğunu düşündürmektedir

Anahtar Kelimeler:

adolesan, çocuk, ekokardiyografi, kardiyak disfonksiyon, tip1diyabet

Early Evaluation of Cardiac Functions by Conventional Echocardiography in Children and Adolescents with Type 1 Diabetes

Objective: It is known that cardiac dysfunction is one of the serious and common complications of type 1 diabetes. The aim of this study was to evaluation early cardiac functions of children and adolescents with type 1 diabetes by conventional echocardiography.Material and Method: This study included 53 children and adolescents with type 1 diabetes and 55 age-sex matched healty children and adolescents. The values of height, weight, body-mass index and blood pressure of the all participants were recorded. Glycated hemoglobin measuring was performed for glycemic control in patients with type 1 diabetes. Myocardial systolic and diastolic functions of all paticipants were assessed by conventional echocardiography.Results: A wave velocity of tricuspid valve was significantly higher (p=0,04) and tricuspid E/A rate was significantly less (p=0,02) in patients with type 1 diabetes than controls. Fractional shortening and ejection fraction of left ventricular revealed less in the patient groups than controls, but they were no statistically significant differences (p values 0,675,0,933 respectively). Statistically significant negative correlation was noted between level of glycated hemoglobin and ejection fraction of left ventricular in patients group (p=0,049, r= -0,669). Conclusion: Determination of right ventricular diastolic dysfunction and negative corrrelation between level of glycated hemoglobin and left ventricular ejection fraction in children and adolescents with type 1 diabetes suggest, that cardiac evaluation of poor glycemic controlled diabetic patients is necessary periodically performing by echocardiography, which is noninvasive diagnostic method.

Keywords:

Adolescent, Child, Echocardiography, Cardiac Dysfunction, Type 1 Diabetes,

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