{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:32:58Z","timestamp":1792787578164,"version":"4.5.0"},"reference-count":81,"publisher":"Wiley","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"HELIOS Research Center","award":["HRC-ID 000416"],"award-info":[{"award-number":["HRC-ID 000416"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>\n                    Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                      <mml:mn fontstyle=\"italic\">11.5<\/mml:mn>\n                      <mml:mo>\u00b1<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">3.1<\/mml:mn>\n                    <\/mml:math>\n                    years and mean disease duration\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                      <mml:mn fontstyle=\"italic\">4.3<\/mml:mn>\n                      <mml:mo>\u00b1<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">3.5<\/mml:mn>\n                    <\/mml:math>\n                    years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.019<\/mml:mn>\n                    <\/mml:math>\n                    ) and circumferential (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.016<\/mml:mn>\n                    <\/mml:math>\n                    ) strain rate both at rest and during exercise (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.021<\/mml:mn>\n                    <\/mml:math>\n                    ). This was more pronounced in T1DM patients with a longer disease duration (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.038<\/mml:mn>\n                    <\/mml:math>\n                    ). T1DM patients with serum\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                      <mml:mi mathvariant=\"normal\">H<\/mml:mi>\n                      <mml:mi mathvariant=\"normal\">b<\/mml:mi>\n                      <mml:msub>\n                        <mml:mrow>\n                          <mml:mi mathvariant=\"normal\">A<\/mml:mi>\n                        <\/mml:mrow>\n                        <mml:mrow>\n                          <mml:mn mathvariant=\"normal\">1<\/mml:mn>\n                          <mml:mi mathvariant=\"normal\">c<\/mml:mi>\n                        <\/mml:mrow>\n                      <\/mml:msub>\n                      <mml:mo>&gt;<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">9<\/mml:mn>\n                      <mml:mi>%<\/mml:mi>\n                    <\/mml:math>\n                    showed impaired longitudinal (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.008<\/mml:mn>\n                    <\/mml:math>\n                    ) and circumferential strain (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.005<\/mml:mn>\n                    <\/mml:math>\n                    ) and a reduced E\/A-ratio (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">0.018<\/mml:mn>\n                    <\/mml:math>\n                    ). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment.\n                  <\/jats:p>","DOI":"10.1155\/2016\/2583747","type":"journal-article","created":{"date-parts":[[2015,12,29]],"date-time":"2015-12-29T16:16:36Z","timestamp":1451405796000},"page":"1-12","source":"Crossref","is-referenced-by-count":47,"title":["Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study"],"prefix":"10.1155","volume":"2016","author":[{"given":"Kai O.","family":"Hensel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten\/Herdecke University, Heusnerstra\u00dfe 40, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Grimmer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten\/Herdecke University, Heusnerstra\u00dfe 40, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Roskopf","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten\/Herdecke University, Heusnerstra\u00dfe 40, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas C.","family":"Jenke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten\/Herdecke University, Heusnerstra\u00dfe 40, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wirth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten\/Herdecke University, Heusnerstra\u00dfe 40, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Heusch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten\/Herdecke University, Heusnerstra\u00dfe 40, 42283 Wuppertal, 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