ArticleCardiovascular diabetology2024
Comprehensive echocardiographic and biomarker assessment of patients with diabetic ketoacidosis.
Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Subclinical cardiac involvement during diabetic ketoacidosis at type 1 diabetes onset in youth: biomarker elevation, altered diastolic filling, and reduced global longitudinal strain: a prospective cohort study.Cardiovascular diabetology · 2026Observational
- Unmasking delayed recovery in severe diabetic ketoacidosis: clinical and biochemical clues from early resuscitation.Annals of pediatric endocrinology & metabolism · 2026Article
- Rapid development of extensive myocardial calcification in a diabetic patient with multi-organ failure: a case report.European heart journal. Case reports · 2026Article
- A 5-hydroxymethylcytosine-based noninvasive model for acute myocardial infarction in type 2 diabetes: implications in cardiovascular outcomes from a 5-year median follow-up study.Cardiovascular diabetology · 2026Article
- Association of cerebrovascular disease with adverse outcomes in patients with diabetic ketoacidosis.Endocrine connections · 2026Article
- Article
- Longitudinal Myocardial Deformation as an Emerging Biomarker for Post-Traumatic Cardiac Dysfunction.Life (Basel, Switzerland) · 2025Review
- Roles of Autophagy, Mitophagy, and Mitochondria in Left Ventricular Remodeling after Myocardial Infarction.Reviews in cardiovascular medicine · 2025Review
- Case report: Takotsubo cardiomyopathy and cardiac arrest in a 9-year-old girl with new-onset diabetes presenting with diabetic ketoacidosis: the chicken or the egg?Frontiers in endocrinology · 2025Article
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5 authors.
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Abstract
backgroundSystemic stress, inflammation, and hydroelectrolytic and acid‒base abnormalities observed during diabetic ketoacidosis (DKA) can cause changes in the heart and even induce cardiovascular damage. We aimed to evaluate the structure and function of the heart during and after a DKA episode via echocardiography and biomarker assessment.
methodsWe performed a transthoracic echocardiogram (TTE) in subjects with an episode of DKA in the first 4-6 h of treatment. We evaluated left ventricular wall thickness, diameters and volumes, as well as systolic and diastolic function using tissue Doppler imaging, pulsed wave Doppler and left ventricular ejection fraction (LVEF). Left ventricular function was also assessed with global longitudinal strain (GLS). We obtained cardiac troponin levels in the first 24 h after admission. A second TTE was performed following the same protocol 6-12 h after the resolution of the DKA episode.
resultsWe included a total of 20 subjects. The mean age was 33 ± 13.6 years; 70% were female, and 70% had type 1 DM. 75% of the patients experienced severe episodes, and the rest experienced moderate episodes. Left ventricular isovolumetric contraction and ejection time were significantly shorter during DKA and prolonged after the resolution of the episodes (47.6 ± 9.9 vs. 62.2 ± 14.1, p = < 0.001) and (218.6 ± 37.9 vs. 265.06 ± 34.7). The isovolumetric relaxation time was also shorter during DKA, (41.72 ± 8.29 vs. 59.32 ± 17.98, p = < 0.001). Volumes and diameters of the left ventricle increased significantly after DKA resolution. We found no difference between LVEF or GLS during and after DKA resolution. 20% of the participants had troponin elevations, half of whom had moderate episodes and half of whom had severe episodes. 35% had LV dysfunction, 28.5% both in GLS and LVEF. 28.5% occurred after DKA resolution, with alterations in GLS.
conclusionsDiabetic ketoacidosis induces changes in the structure and function of the heart, which are mostly transient, reflect the presence of a hyperdynamic state and resolve after the resolution of the episode. Some subjects present with evidence of myocardial injury with elevated cardiac troponin and left ventricular dysfunction.
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