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The relationship between P-wave dispersion and diastolic functions in diabetic children

Published online by Cambridge University Press:  12 March 2010

Reşit Köken ,
Tevfik Demir ,
Tolga Altuğ Şen ,
Ahmet Afşin Kundak ,
Osman Öztekin  and
Faruk Alpay
Reşit Köken*
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
Tevfik Demir
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
Tolga Altuğ Şen
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
Ahmet Afşin Kundak
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
Osman Öztekin
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
Faruk Alpay
Affiliation:
Department of Pediatrics, Medical Faculty, Kocatepe University, Afyonkarahisar, Turkey
*
Correspondence to: Dr Reşit Köken, Akdeniz Üniversitesi Hastanesi, Çocuk Sağlığı ve Hastalıkları AD, Çocuk Nöroloji BD, Dumlupınar Bulvarı, 07059 Antalya/Turkey. Tel: +90 242 249 6552; Fax: +90 272 213 30 66; E-mails: [email protected] and [email protected]
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Abstract

Objective

The aim of this study was to investigate the relations between the P-wave dispersion and diastolic functions in type 1 diabetic children.

Patients

A total of 33 diabetic patients without any cardiovascular disease, with a mean age of 12.3 plus or minus 4.2 years, and 29 healthy controls, with a mean age of 10.4 plus or minus 3.9 years were enrolled for this study. Left and right ventricular functions were assessed by using standard pulsed-wave Doppler echocardiography. P-wave dispersion was calculated by measuring minimum and maximum P-wave duration values on the surface electrocardiogram.

Results

For the diabetic patients, P-wave maximum duration and dispersion was found to be significantly increased compared with healthy controls. Likewise, mitral A velocity and A velocity time integral was significantly increased while the isovolumic contraction time was significantly higher in the diabetics. In tricuspid valve measurements, however, A velocity time integral was found to be significantly higher, whereas the deceleration time was significantly lower in the diabetics. No relation was found between the left ventricle diastolic functions and duration of diabetes, HbA1c levels and P-wave dispersion in the diabetic children. No correlation was found between the diastolic functions and P-wave minimum, maximum duration, and dispersion for all the participants.

Conclusion

In type-1 diabetic children, the diastolic functions of both the ventricles were observed to be affected negatively together. Diabetes might be causing the prolongation of P-wave dispersion, but there was no relationship between the diastolic functions and P-wave dispersion in the diabetic children.

Keywords

Doppler echocardiographyelectrocardiogramchildren
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 2 , April 2010 , pp. 133 - 137
Copyright
Copyright © Cambridge University Press 2010

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References

1.Li, Z, Hertervig, E, Carlson, J, Johansson, C, Olsson, SB, Yuan, S. Dispersion of refractoriness in patients with paroxysmal atrial fibrillation. Evaluation with simultaneous endocardial recordings from both atria. J Electrocardiol 2002; 35: 227–234.CrossRefGoogle ScholarPubMed
2.Li, Z, Hertervig, E, Yuan, S, Yang, Y, Lin, Z, Olsson, SB. Dispersion of atrial repolarization in patients with paroxysmal atrial fibrillation. Europace 2001; 3: 285–291.CrossRefGoogle ScholarPubMed
3.Cheema, AN, Ahmed, MW, Kadish, AH, Goldberger, JJ. Effects of autonomic stimulation and blockade on signal-averaged P wave duration. J Am Coll Cardiol 1995; 26: 497–502.CrossRefGoogle ScholarPubMed
4.Dogan, SM, Aydin, M, Gursurer, M, et al. The increase in P-wave dispersion is associated with the duration of disease in patients with Behcet’s disease. Int J Cardiol 2008; 124: 407–410.CrossRefGoogle ScholarPubMed
5.Dogangun, B, Guzeltas, A, Emul, M, et al. Assesment of p wave dispersion in children treated with risperidon. Neurol Psychiatry Brain Res 2007; 14: 115–118.Google Scholar
6.Gunduz, H, Binak, E, Arinc, H, et al. The relationship between P wave dispersion and diastolic dysfunction. Tex Heart Inst J 2005; 32: 163–167.Google ScholarPubMed
7.Yazici, M, Ozdemir, K, Altunkeser, BB, et al. The effect of diabetes mellitus on the P-wave dispersion. Circ J 2007; 71: 880–883.CrossRefGoogle ScholarPubMed
8.Cosson, S, Kevorkian, JP. Left ventricular diastolic dysfunction: an early sign of diabetic cardiomyopathy? Diabetes Metab 2003; 29: 455–466.CrossRefGoogle ScholarPubMed
9.Jarnert, C, Landstedt-Hallin, L, Malmberg, K, et al. A randomized trial of the impact of strict glycaemic control on myocardial diastolic function and perfusion reserve: a report from the DADD (Diabetes mellitus And Diastolic Dysfunction) study. Eur J Heart Fail 2009; 11: 39–47.CrossRefGoogle ScholarPubMed
10.Karamitsos, TD, Karvounis, HI, Dalamanga, EG, et al. Early diastolic impairment of diabetic heart: the significance of right ventricle. Int J Cardiol 2007; 114: 218–223.CrossRefGoogle ScholarPubMed
11.Freire, CM, Moura, AL, Barbosa Mde, M, Machado, LJ, Nogueira, AI, Ribeiro-Oliveira, A Jr. Left ventricle diastolic dysfunction in diabetes: an update. Arq Bras Endocrinol Metabol 2007; 51: 168–175.CrossRefGoogle ScholarPubMed
12.Vranka, I, Penz, P, Dukat, A. Atrial conduction delay and its association with left atrial dimension, left atrial pressure and left ventricular diastolic dysfunction in patients at risk of atrial fibrillation. Exp Clin Cardiol 2007; 12: 197–201.Google ScholarPubMed
13.Imamoglu, EY, Oztunc, F, Eroglu, AG, Onal, H, Guzeltas, A. Dispersion of the P wave as a test for cardiac autonomic function in diabetic children. Cardiol Young 2008; 18: 581–585.CrossRefGoogle Scholar
14.Tumer, N, Yalcinkaya, F, Ince, E, et al. Blood pressure nomograms for children and adolescents in Turkey. Pediatr Nephrol 1999; 13: 438–443.Google ScholarPubMed
15.Francis, GS. Diabetic cardiomyopathy: fact or fiction? Heart 2001; 85: 247–248.CrossRefGoogle ScholarPubMed
16.Raev, DC. Which left ventricular function is impaired earlier in the evolution of diabetic cardiomyopathy? An echocardiographic study of young type I diabetic patients. Diabetes Care 1994; 17: 633–639.CrossRefGoogle ScholarPubMed
17.Kosmala, W, Przewlocka-Kosmala, M, Mazurek, W. Subclinical right ventricular dysfunction in diabetes mellitus – an ultrasonic strain/strain rate study. Diabet Med 2007; 24: 656–663.CrossRefGoogle ScholarPubMed
18.Perzanowski, C, Ho, AT, Jacobson, AK. Increased P-wave dispersion predicts recurrent atrial fibrillation after cardioversion. J Electrocardiol 2005; 38: 43–46.CrossRefGoogle ScholarPubMed
19.Kose, S, Kilic, A, Iyisoy, A, Kursaklioglu, H, Lenk, MK. P wave duration and P dispersion in healthy children. Turk J Pediatr 2003; 45: 133–135.Google ScholarPubMed
20.Ho, TF, Chia, EL, Yip, WC, Chan, KY. Analysis of P wave and P dispersion in children with secundum atrial septal defect. Ann Noninvasive Electrocardiol 2001; 6: 305–309.Google ScholarPubMed
21.Yavuz, T, Nisli, K, Oner, N, et al. The effects of surgical repair on P-wave dispersion in children with secundum atrial septal defect. Adv Ther 2008; 25: 795–800.CrossRefGoogle ScholarPubMed
22.Tsang, TS, Barnes, ME, Gersh, BJ, Bailey, KR, Seward, JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 2002; 90: 1284–1289.CrossRefGoogle ScholarPubMed