Non-invasive assessment of coronary endothelial function in children and adolescents with type 1 diabetes mellitus using isometric handgrip exercise-MRI: A feasibility study.

Détails

Ressource 1Télécharger: 32053613_BIB_FA9042213A7F.pdf (994.55 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_FA9042213A7F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Non-invasive assessment of coronary endothelial function in children and adolescents with type 1 diabetes mellitus using isometric handgrip exercise-MRI: A feasibility study.
Périodique
PloS one
Auteur(s)
Zwingli G., Yerly J., Mivelaz Y., Stoppa-Vaucher S., Dwyer A.A., Pitteloud N., Stuber M., Hauschild M.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2020
Peer-reviewed
Oui
Volume
15
Numéro
2
Pages
e0228569
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
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.
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.
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.).
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.
Mots-clé
Adolescent, Aorta/pathology, Carotid Intima-Media Thickness, Child, Coronary Vessels/diagnostic imaging, Diabetes Mellitus, Type 1/complications, Diabetes Mellitus, Type 1/physiopathology, Endothelium, Vascular/physiopathology, Exercise, Feasibility Studies, Female, Hand Strength, Heart Diseases/complications, Heart Diseases/physiopathology, Hemodynamics, Humans, Magnetic Resonance Imaging, Male, Pilot Projects, Pulse Wave Analysis, Vasodilation
Pubmed
Web of science
Open Access
Oui
Création de la notice
17/02/2020 17:54
Dernière modification de la notice
15/01/2021 8:12
Données d'usage