Non-invasive assessment of coronary endothelial function in children and adolescents with type 1 diabetes mellitus using isometric handgrip exercise-MRI: A feasibility study
| Autor: | Nelly Pitteloud, Michael Hauschild, Sophie Stoppa-Vaucher, Matthias Stuber, Gaëtan Zwingli, Andrew A. Dwyer, Jérôme Yerly, Yvan Mivelaz |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Hemodynamics Pilot Projects Isometric exercise 030204 cardiovascular system & hematology Adolescents Vascular Medicine Pediatrics Biochemistry Carotid Intima-Media Thickness Diagnostic Radiology Families 0302 clinical medicine Endocrinology Medicine and Health Sciences Coronary Heart Disease Public and Occupational Health Child Pulse wave velocity Children Coronary Arteries Aorta Multidisciplinary Hand Strength Radiology and Imaging Child Health Neurochemistry Arteries Magnetic Resonance Imaging Coronary Vessels Sports Science Vasodilation medicine.anatomical_structure Cardiology Medicine Female Anatomy Neurochemicals Artery Research Article medicine.medical_specialty Adolescent Heart Diseases Imaging Techniques Endocrine Disorders Science 030209 endocrinology & metabolism Pulse Wave Analysis Research and Analysis Methods Nitric Oxide 03 medical and health sciences Diagnostic Medicine Hand strength Diabetes mellitus Internal medicine medicine Diabetes Mellitus Humans Aorta/pathology Coronary Vessels/diagnostic imaging Diabetes Mellitus Type 1/complications Diabetes Mellitus Type 1/physiopathology Endothelium Vascular/physiopathology Exercise Feasibility Studies Heart Diseases/complications Heart Diseases/physiopathology Sports and Exercise Medicine Type 1 diabetes business.industry Biology and Life Sciences Physical Activity medicine.disease Diabetes Mellitus Type 1 Intima-media thickness Age Groups Physical Fitness Metabolic Disorders People and Places Cardiovascular Anatomy Blood Vessels Population Groupings Endothelium Vascular business Neuroscience |
| Zdroj: | PLoS ONE, Vol 15, Iss 2, p e0228569 (2020) PLoS ONE PloS one, vol. 15, no. 2, pp. e0228569 |
| ISSN: | 1932-6203 |
| Popis: | Background Type 1 diabetes mellitus (T1DM) in children and adolescents is associated with significant cardiovascular morbidity and mortality. Early detection of vascular dysfunction is key to patient management yet current assessment techniques are invasive and not suitable for pediatric patient populations. A novel approach using isometric handgrip exercise during magnetic resonance imaging (IHE-MRI) has recently been developed to evaluate coronary endothelial function non-invasively in adults. This project aimed to assess endothelium-dependent coronary arterial response to IHE-MRI in children with T1DM and in age matched healthy controls. Materials and methods Healthy volunteers and children with T1DM (>5 years) were recruited. IHE-MRI cross-sectional coronary artery area measurements were recorded at rest and under stress. Carotid intima media thickness (CIMT) and aortic pulse wave velocity (PWV) were assessed for comparison. Student’s t-tests were used to compare results between groups. Results and discussion Seven children with T1DM (3 female, median 14.8 years, mean 14.8 ± 1.9 years) and 16 healthy controls (7 female, median 14.8 years, mean 14.2 ± 2.4 years) participated. A significant increase in stress-induced cross-sectional coronary area was measured in controls (5.4 mm2 at rest to 6.39 mm2 under stress, 18.8 ± 10.7%, p = 0.0004). In contrast, mean area change in patients with T1DM was not significant (7.17 mm2 at rest to 7.59 mm2 under stress, 10.5% ± 28.1%, p = n.s.). There was no significant difference in the results for neither PWV nor CIMT between patients and controls, (5.3±1.5 m/s vs.4.8±0.7 m/s and 0.4±0.03mm vs.0.46 mm ± 0.03 respectively, both p = n.s.). Conclusions Our pilot study demonstrates the feasibility of using a totally non-invasive IHE-MRI technique in children and adolescents with and without T1DM. Preliminary results suggest a blunted endothelium-dependent coronary vasomotor function in children with T1DM (>5 years). Better knowledge and new methodologies may improve surveillance and care for T1DM patients to reduce cardiovascular morbidity and mortality. |
| Databáze: | OpenAIRE |
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