Can ambulatory blood pressure monitoring detect early diastolic dysfunction in children with type 1 diabetes mellitus: correlations with B-type natriuretic peptide and tissue Doppler findings
| Autor: | Nurettin Ünal, Tülay Demircan, Nuh Yilmaz, Mustafa Kir, Ece Böber, Benhur Şirvan Çetin, Korcan Demir, Ozgur Kizilca, Gül Sağın Saylam |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Type 1 diabetes Ambulatory blood pressure medicine.drug_class business.industry Endocrinology Diabetes and Metabolism Diastole 030209 endocrinology & metabolism 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences symbols.namesake 0302 clinical medicine Blood pressure Tissue Doppler echocardiography Internal medicine Pediatrics Perinatology and Child Health Ambulatory Internal Medicine Natriuretic peptide medicine symbols Cardiology business Doppler effect |
| Zdroj: | Pediatric Diabetes. 17:21-27 |
| ISSN: | 1399-543X |
| DOI: | 10.1111/pedi.12234 |
| Popis: | Aim To evaluate the relationship between 24-h blood pressure (BP) measurements and diastolic heart function evaluated by Doppler tissue imaging and B-type natriuretic peptide (BNP) levels in children with type 1 diabetes mellitus (DM). Patients and methods A total of 32 diabetic and 18 healthy children were enrolled. Spectral Doppler analysis and tissue Doppler measurements were performed by conventional echocardiography. The 24-h ambulatory BP and serum BNP levels were measured. Results Analysis of ambulatory blood pressure monitoring (ABPM) recordings showed that median daytime diastolic BP load were significantly higher in diabetic patients compared to controls [12.35 (4.23–27.23) vs. 2.5 (0–8.7), p = 0.007]. Patients with elevated daytime systolic and diastolic BP loads had significantly higher BNP values compared to patients with normal BP load (31.4 ± 24.36 vs. 11.84 ± 11.25 pg/mL, p = 0.03 and 23.21 ± 15.12 vs. 12.12 ± 14.65 pg/mL, p = 0.03, respectively). Isovolemic contraction time (47.43 ± 7.84 vs. 42.27 ± 7.47, p = 0.045), isovolemic relaxation time (68.84 ± 10.43 vs. 58.77 ± 10.02, p = 0.02), and myocardial performance index (0.45 ± 0.10 vs. 0.37 ± 0.09, p = 0.02) as determined by tissue Doppler echocardiography were significantly high in diabetic patients compared to that of control cases. Ratio of mitral peak early diastolic flow velocity (E) to peak early diastolic myocardial velocities by tissue Doppler echocardiography (E′) was also higher in patients with elevated daytime systolic BP load (E/E′, 6.71 ± 1.97 vs. 4.91 ± 1.02, p = 0.04). Conclusion Elevated BP loads detected by 24-h ambulatory BP measurements in children with type 1 diabetes are associated with increased BNP levels and abnormal tissue Doppler echocardiography indices, indicating early stage cardiac dysfunction. |
| Databáze: | OpenAIRE |
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