Background and Aims Diabetic patients can show signs of cardiac autonomic neuropathy and diabetic cardiomyopathy.
We aimed to determine left ventricular function and cardiac autonomic nervous system function in cardiac-asymptomatic diabetic children and to examine the relationship between cardiac function abnormalities and sex, glycemic control, and diabetes duration.
Methods Left ventricular function was assessed using echocardiography. HRV was computed for each subject by means of standard 24-h time domain measures. The final data analysis was conducted on 57 diabetic patients (mean age 14.4 + 3.09 years, 31 males) and 40 healthy controls (mean age 13.6 + 2.2 years, 19 males).
Results No significant differences were found between patients and controls with respect to systolic and diastolic blood pressure, however heart rate measured during physical exam at rest was significantly higher in the diabetic patient group. HRV indexes were lower in the patient group but not significant. Left ventricular wall dimensions and systolic function were comparable in both groups. The A wave velocities, deceleration time and IVRT were significantly higher in the diabetic group. Tissue Doppler derived myocardial peak systolic velocity (Sm) of LV and the Tei index were normal reflecting the preserved LV systolic function. The mitral early filling velocities (Em) were significantly reduced in the diabetic group, with a consequently significant lower E/A ratio.
Conclusions In conclusion, our diabetic patients had signs of significant left ventricular filling abnormalities. Increased heart rate and lowered HRV indexes although not significant may reflect the early evidence of cardiac autonomic nervous dysfunction.