Kryvonos Y. Optimization of diagnosis of diabetic cardiomyopathy in childhood

The dissertation is devoted to solving the problem of optimization and development of the early diagnosis algorithm of diabetic cardiomyopathy in children and adolescents with type 1 diabetes mellitus and diagnostic criteria for diabetic cardiomyopathy in children. A comprehensive assessment of the parameters of 12-lead ECG and ambulatory ECG monitoring with HRV analysis in children with DM1 was performed. In children with a DM1 duration over 5 years was found more repolarization disorders, including at initiation and on the peak of the action of short / ultrashort acting insulin with increasing heart rate; signs of paroxysmal readiness of the heart rhythm are facilitate increasing arrhythmias rate, including life threatening ventricular. A progressing with a DM1 duration increasing accompanied with a heart rate variability diminishing, as well as increased intramyocardial tension and the diastolic myocardial dysfunction development. The spectrum of adaptive mechanisms conditions according to the level of activity of autonomic regulatory systems is determined on the analysis of HRV with an indicator of regulatory systems activity calculation in children with DM1, which allows a tracking of autonomic nervous system damage dynamics and a diabetic autonomic heart neuropathy progression and treatment effectiveness. First time, an algorithm of early diagnosis of diabetic cardiomyopathy in type 1 diabetes in children has been developed. This algorithm is suitable for diabetic myocardial affection detecting, even before its explicit clinical manifestation. To identify risk groups for the development of life-threatening heart rhythm disorders in patients with newly diagnosed type 1 diabetes in childhood, has been developed an algorithm, which will help to improve diagnostic and supporting program for these patients, which will help to save the lives. Key words: diabetes mellitus, diabetic cardiomyopathy, diagnostic algorithm, QT dispersion, ambulatory ECG monitoring, heart rate variability, diastolic dysfunction, heart failure, sudden death, hypoglycemia.