Children with untreated coeliac disease have sub-clinical cardiac dysfunction: a longitudinal observational analysis.
Study Goal
The researchers aimed to assess cardiac function in children with celiac disease and evaluate the impact of a gluten-free diet on cardiac function.
Results Summary
Untreated celiac disease children showed impaired cardiac function, which improved significantly after one year of a gluten-free diet, particularly in compliant patients. Non-compliant children continued to exhibit persistent cardiac dysfunction.
Population
Children with celiac disease (ages 4.2 ± 1.1 years) and healthy controls.
Effective Dosage
Not specified
Duration
1 year
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten-free diet | decrease | isovolumic relaxation time | CD patients with good dietary compliance | 72.5 ± 4.2 vs. 50.62 ± 2.69 | showed changes in | #1 |
gluten-free diet | decrease | deceleration time | CD patients with good dietary compliance | 121.05 ± 10.1 vs. 99.87 ± 8.5 | showed changes in | #2 |
gluten-free diet | increase | cardiac diastolic function | CD patients with good dietary compliance | - | reflecting improved | #3 |
gluten-free diet | decrease | myocardial performance index | GFD compliant patients | 0.60 ± .03 vs. 0.66 ± .08 | had lower | #4 |
gluten-free diet | increase | load-independent echocardiographic parameters | GFD compliant patients | - | reflecting improvement in | #5 |
- | increase | left ventricle end diastolic dimension | Untreated CD children | 35.33 ± 0.87 vs. 32.90 ± 0.91 mm | had larger | #6 |
- | decrease | left ventricular ejection fraction | Untreated CD children | 20% vs. 0% | had reduced | #7 |
- | increase | myocardial performance index | Untreated CD children | 66% vs. 0% | had a higher | #8 |
- | neutral | Subclinical cardiac dysfunction | CD children at diagnosis | - | is common | #9 |
gluten-free diet | increase | echocardiographic parameters | - | - | Improvement in | #10 |
- | no change | persistent cardiac dysfunction | non-compliant children | - | continue to have | #11 |
INTRODUCTION: We assessed cardiac function (CF) in celiac disease (CD) patients and the effect of gluten-free diet (GFD) on CF. METHODS: Prospective evaluation of CF using conventional and tissue doppler echocardiography in 50 CD patients (age 4.2 ± 1.1 years) at diagnosis and after a year of GFD (group 1), 100 CD children (group 2; 47 compliant and 53 non-compliant) in follow-up and 25 healthy controls. RESULTS: Untreated CD (n = 50) children had larger left ventricle end diastolic dimension (35.33 ± 0.87 vs. 32.90 ± 0.91 mm; p = .04), reduced (<55%) left ventricular ejection fraction (20% vs. 0%; p = .01) and a higher (>0.6) myocardial performance index (MPI, 66% vs. 0%; p ≤ .01) as compared to controls. Re-evaluation after one year with good dietary compliance showed changes in isovolumic relaxation time (72.5 ± 4.2 vs. 50.62 ± 2.69; p = .0001) and deceleration time (121.05 ± 10.1 vs. 99.87 ± 8.5; p = .02), reflecting improved cardiac diastolic function. GFD compliant patients had lower MPI than non-compliant (0.60 ± .03 vs. 0.66 ± .08; p = .04), reflecting improvement in load-independent echocardiographic parameters. CONCLUSIONS: Subclinical cardiac dysfunction is common in CD children at diagnosis. Improvement in echocardiographic parameters occurs with GFD and non-compliant children continue to have persistent cardiac dysfunction.