Assessment of subclinical myocardial dysfunctions in Egyptian children with celiac disease, a cross-sectional study

Abstract

Abstract Background Celiac disease (CD) is a chronic immune-mediated disorder with multiple extraintestinal manifestations. The increased incidence of cardiac morbidities in celiac patients highlights the importance of early detection of subclinical myocardial dysfunctions. In this study, we aimed to assess the cardiac functions and explore early subclinical myocardial dysfunctions in celiac patients by tissue Doppler imaging. Results A cross-sectional analytical study which included 42 celiac patients with CD and 36 age- and sex-matched controls. They were subjected to full medical history and examination and complete transthoracic echocardiography including tissue Doppler imaging to assess cardiac functions. Evidences of early subclinical systolic and diastolic dysfunctions were found in our patients; they had significantly lower tricuspid E/A ratio; lower S, E′, a′ in both ventricles; reduced mitral E′/a′ (2.13 ± 0.87, 2.94 ± 0.061 respectively, p < 0.001); and increased tricuspid E/e′ (6.09 ± 0.8, 4.15 ± 1.33 respectively, p < 0.001) compared to the controls. Biventricular MPI were within normal limits, yet with a significant difference from the control (p = 0.001). lower E′/a′ in the RV is significantly related to the extraintestinal manifestations (1.5 ± 0.48, 2.16 ± 0.71 respectively, p = 0.009). Conclusion Children with CD had subclinical myocardial dysfunction especially in RV which is better detected by tissue Doppler imaging (TDI). These dysfunctions are increased with the presence of extraintestinal manifestations.

Keywords

• Celiac disease
• Myocardial dysfunction
• Tissue Doppler echo
• Children