Evaluation of P-Wave Dispersion, Ventricular Functions, and Atrial Electromechanical Coupling in Children with Type 1 Diabetes Mellitus

Derya Aydın Şahin; Ahmet İrdem; Mehmet Kervancıoğlu; Osman Başpınar; Murat Sucu; Mehmet Keskin; Metin Kılınç

doi:10.5152/EurJTher.2018.785

Authors

Derya Aydın Şahin Division of Pediatric Cardiology, Gaziantep University School of Medicine, Gaziantep https://orcid.org/0000-0002-8520-2335
Ahmet İrdem Division of Pediatric Cardiology, Gaziantep University School of Medicine, Gaziantep https://orcid.org/0000-0002-2565-5674
Mehmet Kervancıoğlu Division of Pediatric Cardiology, Gaziantep University School of Medicine, Gaziantep
Osman Başpınar Division of Pediatric Cardiology, Gaziantep University School of Medicine, Gaziantep
Murat Sucu Department of Cardiology, Gaziantep University School of Medicine, Gaziantep https://orcid.org/0000-0002-3695-5461
Mehmet Keskin Division of Pediatric Endocrinology, Gaziantep University School of Medicine, Gaziantep
Metin Kılınç Division of Pediatric Cardiology, Gaziantep University School of Medicine, Gaziantep

DOI:

https://doi.org/10.5152/EurJTher.2018.785

Keywords:

Atrial electromechanical delay, children, diastolic function, left atrial mechanical function, type 1 diabetes mellitus

Abstract

Objective: The present study aimed to evaluate ventricular diastolic function, inter- and intra-atrial conduction delay, and P wave dispersion in pediatric patients with type 1 diabetes mellitus (DM).
Methods: This study comprised 30 pediatric patients with type 1 DM and 30 healthy children served as the control group. P wave dispersion (Pd )was measured on a 12-channel ECG. Both systolic and diastolic functions of both ventricles were evaluated using conventional and tissue doppler imaging (TDI) echocardiography (ECHO). Atrial electromechanical delay was measured using TDI accompanied with electrocardiography (ECG).
Results: On conventional transthoracic echocardiography (ECHO), the mitral E/A ratio and isovolumetric relaxation times (IVRT) were different between the patients with type 1 DM and the control group (1.67±0.46 vs. 1.95±0.43, p=0.017 and 74.5±7.0 vs. 63.3±5.2, p<0.001, respectively). On TDI, LV septal peak systolic (Sm) and early diastolic (Em) velocities and Em/Am ratio were found to be significantly lower in the patients with type 1 DM than in the control group (p=0.047, p=0.003, and p=0.001, respectively). Regarding atrial electromechanical conduction, prolongation was detected in PA lateral, PA septal, PA tricuspid, and inter-atrial (PA lateral–PA tricuspid) and intra-atrial (PA septal–PA tricuspid) conduction delay (p<0.001, p<0.001, p<0.001, p<0.001, and p<0.05, respectively).
Conclusion: Our findings suggest that intra- and inter-atrial conduction delay, p wave dispersion, and ventricular diastolic functions are abnormal in patients with type 1 DM.

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