Heart Rate Variability and Diastolic Dysfunction in Children with Type 1 Diabetes: A Cross-Sectional Study

Gülay Can Yılmaz; Perran Boran; Levent Yılmaz; Mehmet Ali Astarcıoglu; Emre Ertürk; Engin Tutar; Ayşe Gülnur Tokuç

Makale detayları

Heart Rate Variability and Diastolic Dysfunction in Children with Type 1 Diabetes: A Cross-Sectional Study

Yazarlar:

Gülay Can Yılmaz | Perran Boran | Levent Yılmaz | Mehmet Ali Astarcıoglu | Emre Ertürk | Engin Tutar | Ayşe Gülnur Tokuç

Yayıncı:

Mugla Sitki Kocman University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi Vol.12 Issue 2, pp.113-119

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357185

pISSN:

2148-8118

Anahtar kelimeler:

Özet:

 Reduced heart rate variability HRV is an indicator of subclinical cardiac autonomic dysfunction. This study aimed to evaluate the relationship between HRV and diastolic dysfunction in children with type 1 diabetes mellitus T1DM, and to examine the impact of glycemic control and diabetes duration on subclinical cardiovascular changes. This cross-sectional study included 57 children with T1DM and 40 age and sex matched healthy controls. HRV was assessed using 24-hour Holter monitoring, and diastolic function was evaluated with Doppler echocardiography. Children with type 1 diabetes had lower heart rate variability indices compared to controls, particularly in those with poor glycemic control. Early diastolic dysfunction was observed in the diabetic group, indicated by higher A-wave velocities 67.0  5.9 cms vs. 62.5  7.4 cms, p0.004, prolonged deceleration time 181.3  42.5 ms vs. 143.3  25.1 ms, p0.001, and increased isovolumic relaxation time 52.6  9.8 ms vs. 44.4  10.2 ms, p0.001. Chronic high blood glucose levels and longer diabetes duration were strongly associated with both reduced heart rate variability and diastolic abnormalities. In conclusion, this study highlights the potential of heart rate variability parameters as early markers of subclinical myocardial changes in children with type 1 diabetes. Early detection and targeted interventions based on these parameters may may contribute to reducing long-term cardiovascular risks in this population.

 Reduced heart rate variability HRV is an indicator of subclinical cardiac autonomic dysfunction. This study aimed to evaluate the relationship between HRV and diastolic dysfunction in children with type 1 diabetes mellitus T1DM, and to examine the impact of glycemic control and diabetes duration on subclinical cardiovascular changes. This cross-sectional study included 57 children with T1DM and 40 age and sex matched healthy controls. HRV was assessed using 24-hour Holter monitoring, and diastolic function was evaluated with Doppler echocardiography. Children with type 1 diabetes had lower heart rate variability indices compared to controls, particularly in those with poor glycemic control. Early diastolic dysfunction was observed in the diabetic group, indicated by higher A-wave velocities 67.0  5.9 cms vs. 62.5  7.4 cms, p0.004, prolonged deceleration time 181.3  42.5 ms vs. 143.3  25.1 ms, p0.001, and increased isovolumic relaxation time 52.6  9.8 ms vs. 44.4  10.2 ms, p0.001. Chronic high blood glucose levels and longer diabetes duration were strongly associated with both reduced heart rate variability and diastolic abnormalities. In conclusion, this study highlights the potential of heart rate variability parameters as early markers of subclinical myocardial changes in children with type 1 diabetes. Early detection and targeted interventions based on these parameters may may contribute to reducing long-term cardiovascular risks in this population.

 Reduced heart rate variability HRV is an indicator of subclinical cardiac autonomic dysfunction. This study aimed to evaluate the relationship between HRV and diastolic dysfunction in children with type 1 diabetes mellitus T1DM, and to examine the impact of glycemic control and diabetes duration on subclinical cardiovascular changes. This cross-sectional study included 57 children with T1DM and 40 age and sex matched healthy controls. HRV was assessed using 24-hour Holter monitoring, and diastolic function was evaluated with Doppler echocardiography. Children with type 1 diabetes had lower heart rate variability indices compared to controls, particularly in those with poor glycemic control. Early diastolic dysfunction was observed in the diabetic group, indicated by higher A-wave velocities 67.0  5.9 cms vs. 62.5  7.4 cms, p0.004, prolonged deceleration time 181.3  42.5 ms vs. 143.3  25.1 ms, p0.001, and increased isovolumic relaxation time 52.6  9.8 ms vs. 44.4  10.2 ms, p0.001. Chronic high blood glucose levels and longer diabetes duration were strongly associated with both reduced heart rate variability and diastolic abnormalities. In conclusion, this study highlights the potential of heart rate variability parameters as early markers of subclinical myocardial changes in children with type 1 diabetes. Early detection and targeted interventions based on these parameters may may contribute to reducing long-term cardiovascular risks in this population.

 Azalmış kalp hızı değişkenliği KHD, subklinik kardiyak otonomik disfonksiyonun bir göstergesidir. Bu çalışma, tip 1 diyabetli çocuklarda KHD ile diyastolik disfonksiyon arasındaki ilişkiyi değerlendirmeyi ve glisemik kontrol ile diyabet süresinin subklinik kardiyovasküler değişiklikler üzerindeki etkisini incelemeyi amaçlamıştır. Kesitsel tasarıma sahip bu çalışmaya, tip 1 diyabetli 57 çocuk ile yaş ve cinsiyet açısından eşleştirilmiş 40 sağlıklı kontrol dahil edilmiştir. KHD, 24 saatlik Holter monitörizasyonu ile; diyastolik fonksiyon ise Doppler ekokardiyografi kullanılarak değerlendirilmiştir. Tip 1 diyabetli çocuklarda, özellikle glisemik kontrolü kötü olanlarda, kalp hızı değişkenliği indeksleri kontrol grubuna kıyasla daha düşük bulunmuştur. Diyabetik grupta, A dalgası hızının yüksek olması 67.0  5.9 cms vs. 62.5  7.4 cms , p0.004, deselerasyon zamanının uzaması 181.3  42.5 ms vs. 143.3  25.1 ms, p0.001 ve izovolümetrik gevşeme süresinin artması 52.6  9.8 ms vs. 44.4  10.2 ms, p0.001 ile karakterize erken diyastolik disfonksiyon saptanmıştır. Kronik yüksek kan şekeri düzeyleri ve uzun diyabet süresi, hem azalmış kalp hızı değişkenliği hem de diyastolik anormalliklerle güçlü bir şekilde ilişkili bulunmuştur. Sonuç olarak, bu çalışma, kalp hızı değişkenliği parametrelerinin tip 1 diyabetli çocuklarda subklinik miyokardiyal değişikliklerin erken belirteçleri olabileceğini ortaya koymaktadır. Bu parametrelere dayalı erken tanı ve hedefe yönelik müdahaleler, bu popülasyonda uzun vadeli kardiyovasküler risklerin azaltılmasına katkı sağlayabilir.

Makale detayları

Heart Rate Variability and Diastolic Dysfunction in Children with Type 1 Diabetes: A Cross-Sectional Study

Yazarlar:

Gülay Can Yılmaz | Perran Boran | Levent Yılmaz | Mehmet Ali Astarcıoglu | Emre Ertürk | Engin Tutar | Ayşe Gülnur Tokuç

Yayıncı:

Mugla Sitki Kocman University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi Vol.12 Issue 2, pp.113-119

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357185

pISSN:

2148-8118

Diastolic Dysfunction

Heart Rate Variability

Cardiac Autonomic Neuropathy

Type 1 DiabetesDiyastolik Disfonksiyon

Kalp Hızı Değişkenliği

Kardiyak Otonom Nöropati

Tip 1 Diyabet

Sayı

Makale detayları

Yazarlar: Gülay Can Yılmaz | Perran Boran | Levent Yılmaz | Mehmet Ali Astarcıoglu | Emre Ertürk | Engin Tutar | Ayşe Gülnur Tokuç

Yayıncı: Mugla Sitki Kocman University

Ana Başlıklar: Klinik Tıp Bilimleri (Diğer)

Dergi: Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi Vol.12 Issue 2, pp.113-119

Belge Tipi: Makale

Yayın Tarihi: 8/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001357185

pISSN: 2148-8118

Sayı

Yazarlar:

Gülay Can Yılmaz | Perran Boran | Levent Yılmaz | Mehmet Ali Astarcıoglu | Emre Ertürk | Engin Tutar | Ayşe Gülnur Tokuç

Yayıncı:

Mugla Sitki Kocman University

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer)

Dergi:

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi Vol.12 Issue 2, pp.113-119

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357185

pISSN:

2148-8118