Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study
BackgroundCardiac dysfunction and endothelial damage are known complications of type 1 diabetes mellitus (T1D) mainly affecting adults. However, some studies have shown that subclinical myocardial impairment already present during adolescence. Myocardial work (MW) has emerged as an afterload-indepen...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1476456/full |
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| author | Martina Ghirardo Martina Ghirardo Irene Cattapan Irene Cattapan Jolanda Sabatino Jolanda Sabatino Alice Pozza Alice Pozza Jennifer Fumanelli Jennifer Fumanelli Martina Avesani Joaquin Gutierrez De Rubalcava Doblas Carlo Moretti Biagio Castaldi Giovanni Di Salvo |
| author_facet | Martina Ghirardo Martina Ghirardo Irene Cattapan Irene Cattapan Jolanda Sabatino Jolanda Sabatino Alice Pozza Alice Pozza Jennifer Fumanelli Jennifer Fumanelli Martina Avesani Joaquin Gutierrez De Rubalcava Doblas Carlo Moretti Biagio Castaldi Giovanni Di Salvo |
| author_sort | Martina Ghirardo |
| collection | DOAJ |
| description | BackgroundCardiac dysfunction and endothelial damage are known complications of type 1 diabetes mellitus (T1D) mainly affecting adults. However, some studies have shown that subclinical myocardial impairment already present during adolescence. Myocardial work (MW) has emerged as an afterload-independent tool that allows early identification of subclinical damage. This study aims to provide a comprehensive non-invasive cardiovascular evaluation of T1D adolescents using both conventional and advanced echocardiography.MethodsWe enrolled 31 patients, aged between 13 and 19 years, who were diagnosed with T1D for at least 10 years and were followed up by the Paediatric Diabetology Unit of our institution. We collected data relating to anthropometry, lifestyle, blood tests, glycemic control parameters, and conventional and advanced echocardiographic measurements. A comparison of MW parameters with the data from 31 age- and sex-matched healthy volunteers from a previous study in our lab was carried out.ResultsIn our population, the glycemic control parameters showed suboptimal control. While diastolic parameters were in the normal range for all the patients, E′ velocities and left atrial diameter were significantly worse in patients with poorer glycemic controls. Global longitudinal strain (GLS), global work index (GWI), and global work efficiency (GWE) were significantly lower in the T1D population compared to those in the healthy population (p < 0.001), while global wasted work was significantly higher in the T1D population (p < 0.001). Patients with stage 1 hypertension or a pre-hypertensive state exhibited pathological pulse wave velocities with values exceeding 8 m/s (>99th percentile).ConclusionsTo the best of our knowledge, this was the first study to investigate MW in T1D adolescents. The descriptive parameters of GLS and MW showed subclinical cardiac damage already during this timeframe. Therefore, these tools should be integrated into the cardiovascular assessment of diabetic adolescents, and preventive strategies should be implemented to maximize glycemic and pressure control effectiveness. |
| format | Article |
| id | doaj-art-7d06088a4ec943efbca9df58da3498f9 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-7d06088a4ec943efbca9df58da3498f92025-02-05T04:11:07ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-02-011110.3389/fcvm.2024.14764561476456Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work studyMartina Ghirardo0Martina Ghirardo1Irene Cattapan2Irene Cattapan3Jolanda Sabatino4Jolanda Sabatino5Alice Pozza6Alice Pozza7Jennifer Fumanelli8Jennifer Fumanelli9Martina Avesani10Joaquin Gutierrez De Rubalcava Doblas11Carlo Moretti12Biagio Castaldi13Giovanni Di Salvo14Division of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyPediatric Department, San Bortolo Hospital, Vicenza, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyPhD School in Developmental Medicine and Health Planning Sciences, University of Padua, Padua, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyDivision of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyPhD School in Developmental Medicine and Health Planning Sciences, University of Padua, Padua, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyPhD School in Developmental Medicine and Health Planning Sciences, University of Padua, Padua, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyPediatric Diabetology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyPediatric Diabetology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyDivision of Pediatric Cardiology, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, ItalyBackgroundCardiac dysfunction and endothelial damage are known complications of type 1 diabetes mellitus (T1D) mainly affecting adults. However, some studies have shown that subclinical myocardial impairment already present during adolescence. Myocardial work (MW) has emerged as an afterload-independent tool that allows early identification of subclinical damage. This study aims to provide a comprehensive non-invasive cardiovascular evaluation of T1D adolescents using both conventional and advanced echocardiography.MethodsWe enrolled 31 patients, aged between 13 and 19 years, who were diagnosed with T1D for at least 10 years and were followed up by the Paediatric Diabetology Unit of our institution. We collected data relating to anthropometry, lifestyle, blood tests, glycemic control parameters, and conventional and advanced echocardiographic measurements. A comparison of MW parameters with the data from 31 age- and sex-matched healthy volunteers from a previous study in our lab was carried out.ResultsIn our population, the glycemic control parameters showed suboptimal control. While diastolic parameters were in the normal range for all the patients, E′ velocities and left atrial diameter were significantly worse in patients with poorer glycemic controls. Global longitudinal strain (GLS), global work index (GWI), and global work efficiency (GWE) were significantly lower in the T1D population compared to those in the healthy population (p < 0.001), while global wasted work was significantly higher in the T1D population (p < 0.001). Patients with stage 1 hypertension or a pre-hypertensive state exhibited pathological pulse wave velocities with values exceeding 8 m/s (>99th percentile).ConclusionsTo the best of our knowledge, this was the first study to investigate MW in T1D adolescents. The descriptive parameters of GLS and MW showed subclinical cardiac damage already during this timeframe. Therefore, these tools should be integrated into the cardiovascular assessment of diabetic adolescents, and preventive strategies should be implemented to maximize glycemic and pressure control effectiveness.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1476456/fullGLSmyocardial worktype 1 diabetes mellitusdiabetic adolescentsadvanced echocardiography |
| spellingShingle | Martina Ghirardo Martina Ghirardo Irene Cattapan Irene Cattapan Jolanda Sabatino Jolanda Sabatino Alice Pozza Alice Pozza Jennifer Fumanelli Jennifer Fumanelli Martina Avesani Joaquin Gutierrez De Rubalcava Doblas Carlo Moretti Biagio Castaldi Giovanni Di Salvo Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study Frontiers in Cardiovascular Medicine GLS myocardial work type 1 diabetes mellitus diabetic adolescents advanced echocardiography |
| title | Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study |
| title_full | Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study |
| title_fullStr | Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study |
| title_full_unstemmed | Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study |
| title_short | Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study |
| title_sort | cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus an ultrasound derived myocardial work study |
| topic | GLS myocardial work type 1 diabetes mellitus diabetic adolescents advanced echocardiography |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1476456/full |
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