Impactul hemoglobinei glicate asupra indicelui de masă ventriculară stângă la copiii cu diabet zaharat de tip 1

Paediatrics Department, Nicolae Testemitanu SUMPhBackground. The presence of high left ventricular mass index (LVMI) is reportedly an independent predictor of increased cardiovascular morbidity and mortality. However, data regarding the association between glycated hemoglobin (HbA1c) and LVMI in children with type 1 diabetes (T1D) are limited. Objective of the study. Evaluation of the effect of glycated hemoglobin on LVMI in children with T1D. Material and Methods. 30 children with T1D (mean age = 13.8 ± 1.8 years; gender M (17) / F (13); duration of T1D = 6.69 ± 2.34 years) were submitted to clinical evaluation, laboratory tests (HbA1c level), and echocardiography (LV function and structure). Statistical analysis – SPSS version 20. The research received a favorable opinion of the Research Ethics Committee of the "NicolaeTestemitanu" SUMPh. Results. The correlational study between the HbA1c and the LVMI revealed a statistically significant positive correlation coefficient (r = 0.5*, p = 0.038). also with other parameters of the structure and function of the LV: LV diastolic diameter (mm) (r = 0.7**, p < 0.001), LV systolic diameter (mm) (r = 0.7**, p < 0.001), interventricular septal thickness at end-diastole (mm) (r = 0.5*, p = 0.036), posterior wall thickness at end-diastole (mm) (r = 0.5*, p = 0.032), LV diastolic volume (ml) (r = 0.5*, p = 0.025), LV systolic volume (ml) (r = 0.6**, p = 0.01), LV ejection fraction (%) (r = 0.7**, p = 0.001), LV fractional shortening (%) (r = 0.6**, p = 0.002). Conclusion. The results of the study confirm that the increased value of the glycated hemoglobin was associated with a consensual and proportional increase of the value of left ventricular mass index - marker for pathological ventricular remodeling, but, and with other parameters of the left ventricle.Introducere. Indicele de masă miocardică ventriculară stângă (IMMVS) crescut este un predictor independent al morbidității și mortalității cardiovasculare înalte. Cu toate acestea, date privind asocierea dintre hemoglobina glicată (HbA1c) și IMMVS, la copiii cu diabet de tip 1 (DZ1), sunt limitate. Scopul lucrării. Evaluarea efectului HbA1c asupra IMMVS, la copiii cu DZ1. Material și metode. Un număr de 30 de copii cu DZ1 (vârsta medie = 13,8±1,8 ani; sex M (17) / F (13); durata T1D = 6,69±2,34 ani) au fost evaluați clinic, prin teste de laborator (nivel HbA1c) și ecocardiografie (funcția și structura VS). Analiza statistică a fost realizată prin Programul SPSS versiunea 20. Cercetarea a primit aviz favorabil al Comitetului de etică al cercetării al USMF „Nicolae Testemițanu”. Rezultate. Studiul relației dintre HbA1c și IMMVS a relevat un coeficient de corelație pozitiv, cu semnificație statistică (r = 0,5*, p = 0,038), de asemenea, și cu alți parametri de structură și de funcție ventriculară stângă: diametru diastolic al VS (mm) (r = 0,7**, p <0,001), diametru sistolic al VS (mm) (r = 0,7**, p <0,001), grosimea septului interventricular (mm) (r = 0,5*, p = 0,036), grosimea peretelui posterior al VS (mm) (r = 0,5*, p = 0,032), volumul diastolic al VS (ml) (r = 0,5*, p = 0,025), volumul sistolic al VS (ml) (r = 0,6**, p = 0,01), fracția de ejecție a VS (%) (r = 0,7**, p = 0,001), fracția de scurtare a VS (%) (r = 0,6**, p = 0,002). Concluzii. Rezultatele confirmă faptul că, valoarea crescută a hemoglobinei glicate a fost asociată cu o creștere consensuală și proporțională a valorii indicelui masei miocardului ventriculului stâng - marker pentru remodelarea ventriculară patologică, de asemenea și cu alți parametri ai acestuia

Corelații statistice ale scorului pediatric al sindromului metabolic

Background. To the best of our research, the present study is the first study in which the pediatric metabolic syndrome score and its correlations in the children are validated. Objective of the study. To study the correlation coefficient of the pediatric MS score with the clinical and paraclinical parameters in children with metabolic syndrome. Material and Method. A observational analytical cohort study. The study was conducted on 145 children (aged 10-18 years). Pediatric MS score was calculated by using the following formula = (2xWC/h) + (Glu (mmol/l)/5.6) + (TG (mmol/l)/1.7) + (sBP/130) - (HDLc (mmol/l)/1.02). Statistical Analysis Used - SPSS version 20. Results. The following scores were found (participants aged 16-18 years were not included in the study, considering their small number, thus requiring application of other formulas): L0 (non-MS) – 2,20±0,05, L1 (MS) – 2,58±0,11 (p>0,05).The correlation coefficient of the pediatric MS score with the clinical and paraclinical parameters was assessed, showing a strong positive association with TG (+ 0.9**, p<0.001), waist, age, weight, BMI, BSA, AI, SBP, DBP, LDLc (+ 0.3**, p<0.001), HG (+ 0.24**, p<0.001), Glu (+ 0.2**, p<0,05), OD (+ 0.2*, p<0.05), LVPWd (+ 0.23**, p<0.001), LVMM (+ 0.2*, p<0.05), and strong negative association with HDLc (-0.6**, p<0.001), WHR (-0.21*, p<0.05). Conclusion. In conclusion, the results of study indicated that the validity of pediatric MS score for predicting it, were high. The pediatric MS score is simple and practical, it could be used in clinical and research practice. Introducere. În ceea ce privește cercetările noastre, prezentul studiu este primul studiu în care scorul sindromului metabolic pediatric și corelațiile sale la copii sunt validate. Scopul lucrării. Studierea coeficientului de corelație a scorului pediatric al SM cu parametrii clinici și paraclinici la copiii cu sindrom metabolic. Material și Metode. Studiu analitic, observațional, de cohortă. Au fost incluși 145 de copii. Scorul pediatric al SM a fost calculat folosind formula generală: (2xCA/h) + (Glu (mmol/l)/ref.) + (TG (mmol/l)/ref.) + (TAs/ref.) - (HDLc (mmol/l)/ref. (sex masculin/sex feminin). Analiza statistică folosită - SPSS versiunea 20. Rezultate. Au fost înregistrate scorurile (nu au fost incluși copii cu vârsta 16-18 ani, având în vedere numărul mic al acestora și necesitatea aplicării altor formule): L0 (non-SM) – 2,20±0,05, L1 (SM) – 2,58±0,11 (p>0,05). Corelații ale scorului pediatric al SM cu parametrii clinici și paraclinici s-au înregistrat: o corelație statistic semnificativă, de intensitate puternică pozitivă cu TG (+0,9**, p<0,001), slabe, pozitive cu talia, vârsta, greutatea, IMC, ASC, IA, TAs, TAd, LDLc (+0,3**, p<0,001), CF (+0,24**, p<0,001), Glu (+0,2**, p<0,05), durata obezității (+0,2*, p<0,05), PPVS (+0,23**, p<0,001), MMVS (+0,2*, p<0,05), negative cu HDLc (-0,6**, p<0,001), IAF (-0,21*, p<0,05). Concluzii. În concluzie, rezultatele studiului au indicat că valabilitatea scorului pediatric al SM pentru prezicerea acestuia a fost înaltă. Scorul dat este simplu și practic, poate fi utilizat în practica clinică și de cercetare

Ремоделирование сердца у детей с метаболическим синдромом

IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”, Departamentul Pediatrie, IMSP Institutul Mamei şi Copilului, IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”, Catedra EndocrinologieAim. To study myocardial remodeling in children with metabolic syndrome. Material and methods. Structural conditions of the myocardium were studied with echocardiography, and determination of left ventricular remodeling type was made in 145 patients aged 10-18 years. Results. According to theInternational Diabetes Federationcriteria, metabolic syndrome was confi rmed in 36,55%, non-metabolic syndrome – 63,45%.In the left ventricle: normal stare – 62,1%, concentric hypertrophy – 27,6%, concentric remodeling – 5,5%, eccentric hypertrophy – 4,8%. Conclusion. In children, metabolic syndrome is the key factor further influencing left ventricular geometry.Цель исследования. Изучить характер ремоделирования миокарда у детей с метаболическим синдромом. Материалы и методы. Обследовано 145 больных, в возрасте от 10 до 18 лет. Структурно состояние миокарда оценено методом эхокардиографии. Произведено определение типа ремоделирования левого желудочка. Результаты. По критериям Международной Федерации Диабета метаболический синдром подтвержден в 36,55%, неметаболический синдром - 63,45%. В левом желудочке: нормальное состояние ‒ 62,1%, концентрическая гипертрофия ‒ 27,6%, концентрическое ремоделирование ‒ 5,5%, эксцентрическая гипертрофия ‒ 4,8%. Заключение. У детей метаболический синдром является ключевым фактором, влияющим на геометрию левого желудочка

Сердечно-сосудистые заболевания при сахарном диабете

IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”, Departamentul Pediatrie, IMSP Institutul Mamei şi Copilului, IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”, Catedra Endocrinologie, IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”, Catedra de Fiziopatologie și fiziopatologie clinicăIntroduction. Diabetes is one of cardiometabolic syndrome, considered as an important cardiovascular risk factor, having an significant impact in cardiovascular morbidity and mortality. The aim. Raising awareness of cardiovascular disease in diabetic pathology. Material and methods. Analysis of recent bibliographic data aimed at presenting cardiovascular disease in diabetes. Results. Studies report cardiovascular impairment at subjects with diabetes. Diabetic cardiomyopathy is a distinct clinical entity and has clinical aspects ranging from asymptomatic to heart failure. Recognized diagnostic modalities are cardiac biomarkers, cardiac imaging and endomyocardial biopsy. There are new therapies that are being developed, in addition to conventional ones, including microRNA estimation and stem cell therapies in its treatment and prevention. Conclusions. The prevalence of diabetic cardiomyopathy increases in parallel with the increase of diabetes, respectively, it is necessary to implement prevention and treatment measures, aimed to reduce the risk of morbidity and premature mortality.Введение. Cахарный диабет представлен кардиометаболическим синдромом, и считается важным фактором риска для развития сердечно-сосудистых заболеваний, имеет важную роль в заболеваемости и смертности от сердечно-сосудистой патологии. Цель работы. Повышение осведомленности о сердечно-сосудистых заболеваниях при диабетической патологии. Материал и методы. Анализ современной научной литературы, описывающей сердечно-сосудистые нарушения при диабете. Результаты. Исследования доказывают связь сердечно-сосудистых заболеванияй у пациентов с сахарным диабетом. Диабетическая кардиомиопатия является клиническим заболеванием с разнообразной клинической картиной: от отсутствия симптоматики до сердечной недостаточности. Признанными диагностическими методами являются биомаркеры сердца, визуализация сердца и эндомиокардиальная биопсия. Существуют новые методы лечения, помимо стандартной методики, в том числе с опеределением уровня микроРНК, терапия клеточными штаммами для лечения и профилактики диабетической кардиомиопатии. Выводы. Распространенность диабетической кардиомиопатии растёт параллельно с ростом заболеваемости сахарным диабетом, необходимо осуществление профилактических и лечебных мероприятий, направленных на снижение риска заболеваемости и преждевременной смертности

Pulmonary embolism associated with acute ST-segment elevation myocardial infarction

Pulmonary embolism (PE) is a potentially fatal condition that presents with shortness of breath and chest pain. Al- though an electrocardiogram (ECG) may show changes associated with PE, ST elevation mimicking ST elevation myo- cardial infarction is not common in patients with acute PE. This presentation documents the case of a 67-year-old man who presented to the emergency department with dyspnea and chest pain. ECG data indicated anterior septal myocardial infarction and acute ischemia of the lower parts of the left ventricle. Cardiac catheterization did not reveal atherosclerotic lesions of the coronary arteries, but revealed an anomaly in the filling of the right coronary artery with embolic masses. Further examination of the patient revealed massive bilateral pulmonary embolism. In this presentation, we emphasize the need to evaluate patients with PE who present with chest pain, dyspnea, or both, even when ECG findings suggest a cardiac etiology. We also present a brief discussion of possible mechanisms for ST elevation in pulmonary embolism.Embolia pulmonară (EP) este o afecțiune potențial letală care se manifestă cu durere toracică sau dispnee pronunțată. Deși electrocardiograma (ECG) poate prezenta anomalii asociate EP, supradeniverarea de segment ST, caracteristică pentru infarctul miocardic acut anteroseptal (IMA), nu este caracteristică pentru pacienții cu EP acută. Această prezenta- re documentează cazul unui bărbat de 67 de ani care s-a prezentat la Unitatea primiri urgențe cu dispnee și durere retros- ternală. Datele ECG au sugerat un infarct miocardic anteroseptal și ischemie acută zona inferioară a ventriculului stâng. Cateterismul cardiac nu a depistat leziuni aterosclerotice ale arterelor coronare, dar a descoperit o anomalie de umplere embolică în artera coronară dreaptă. Examinarea ulterioară a pacientului a stabilit un embolism pulmonar bilateral masiv. Prin această prezentare accentuăm necesitatea investigării pacienților cu EP, care se prezintă cu durere toracică, dispnee sau ambele, chiar când modificările ECG sugerează o etiologie cardiacă. Prezentăm și o scurtă discuție despre eventualele mecanisme ale supradenivelării segmentului ST în embolismul pulmonar.Легочная эмболия (ТЭЛА) является потенциально смертельным состоянием, которое проявляется одышкой, болью в груди. Хотя электрокардиограмма (ЭКГ) может показать ряд изменеий, связанных с ТЭЛА, подъем сег- мента ST, характерный для острого передне-перегородочного инфаркта миокарда (ОИМ), не характерен для па- циентов с острой ТЭЛА. В этой презентации задокументирован случай 67-летнего мужчины, который поступил в отделение неотложной помощи с одышкой и загрудинной болью. Данные ЭКГ свидетельствовали о передне-пе- регородочном инфаркте миокарда и острой ишемии нижних отделов левого желудочка. Катетеризация сердца не выявила атеросклеротического поражения коронарных артерий, но выявила аномалию наполнения правой коронарной артерии эмболическими массами. При дальнейшем обследовании больного выявлена массивная дву- сторонняя тромбоэмболия легочной артерии. В этой презентации мы подчеркиваем необходимость обследования пациентов с ТЭЛА, которые обращаются с болью в груди, одышкой или и тем, и другим, даже когда изменения ЭКГ указывают на сердечную этиологию. Мы также представляем краткое обсуждение возможных механизмов подъема сегмента ST при легочной эмболии

Association of metabolic syndrome and hypertension with left ventricular geometry in children

The 7th International Medical Congress for Students and Young Doctors, May 3-5, 2018Introduction. The metabolic syndrome (MS) in association with increased left ventricular myocardial mass (LV Mass), LV myocardial mass index (LVMI), LV hypertrophy (LVH) is an important risk factor for cardiovascular diseases which occur in childhood. Aim of the study. Study of the MS's influence on LV Mass, LVMI and cardiac remodeling in the hypertensive pediatric population. Materials and methods. 60 children aged 10 - 18 years were enrolled in the study. Study group included 22 children with MS, and the control group - 38 children with pre-MS. The diagnosis of MS was established according to the International Diabetes Federation criteria (IDF, 2007). Respondents were examined through transthoracic echocardiography. Results. According to the IDF criteria, MS was confirmed in 36.4%, pre-SM at 63.6%. LV Mass: pre-SM - 151.4±56.2, score Z - 0.15±0.9, those with SM - 167.3 ± 48.8, score Z - 0.24±1.3. LV Mass > 95th percentile was in ≈ 20% of the pre-MS group and in ≈ 45% in patients with MS. LVMI in the control group - 36.3±8.4 vs baseline - 38.7±10, LVMI>95th percentile was determined in ≈ 15% vs ≈ 35%. Left ventricle posterior wall relative thickness: 0.39±0.05 vs 0.42±0.05. In the left ventricle: normal stare 55.5% (MS) vs 80.4% (pre-SM), concentric hypertrophy 30.4% vs 5.2% concentric remodeling 8.1% vs 4.7% eccentric hypertrophy - 6 % vs 9.7%. Of all MS components, AHT in 60% of cases was associated with LVMM and VS hypertrophy in the working group and 40% in the control group. Conclusions. All of the MS components, AHT was more often associated with LV, LVM index, LV hypertrophy, especially among the boys

Корреляция между гликированным гемоглобином и липидным профилем при сахарном диабете 1 типа

Background. Pediatric patients with type 1 diabetes (T1D) have an increased prevalence of dyslipidemia, which contributes to their high risk of cardiovascular diseases (CVDs). Aim. This study is an attempt to determine the correlation between hemoglobin A1c (HbA1c) and serum lipid profile in children with T1D. Material and methods. A total of 45 children with T1D (aged 10-18 years; gender M (25) / F (20); duration of T1D ≥ 5 years; absence of hypertension, insulin therapy) were included in this study. The sera were analyzed for HbA1c, total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Dyslipidemia was defined according to the Third Report of the National Cholesterol Education Program. Diabetes was defined as per American Diabetes Association criteria. The correlation of HbA1c with individual lipid indexes was analyzed. The statistical analysis was done by SPSS statistical package version 20.0. Results. The mean age ± standard deviation of participants was 15.71 ± 2.40. There was a significant positive correlation between HbA1c, TC, TG, and LDL-C. The correlation between HbA1c and HDL-C was negative and was statistically nonsignificant. Patients with an HbA1c value greater than 7.0% had significantly higher values of cholesterol, LDL-C, and TG, compared with patients with an HbA1c value of up to 7.0%. Conclusions. HbA1c can also be used as a predictor of dyslipidemia and thus early diagnosis of dyslipidemia can be used as a preventive measure for the development of CVD in children with T1D.Введение. У детей с сахарным диабетом 1 типа (СД1) отмечается повышенная распространенность случаев дислипидемии, что способствует повышению риска развития сердечно-сосудистых заболеваний (ССЗ). Цель. Определить корреляцию между гемоглобином A1c (HbA1c) и липидным профилем сыворотки у детей с СД1. Материалы и методы. В исследование включено 45 детей с СД1 (возраст 10–18 лет, пол М (25)/Ж (20), длительность СД1 ≥ 5 лет, отсутствие артериальной гипертензии, инсулинотерапия). Цельную кровь и сыворотку анализировали на содержание сахара в крови натощак, HbA1c, общего холестерина (CHOL), триглицеридов (TR), холестерина липопротеинов высокой плотности (HDL-C) и холестерина липопротеинов низкой плотности (LDL-C). Дислипидемия была определена в соответствии с рекомендациями Группы экспертов по ССЗ и снижению риска их развития у детей и подростков Национального института сердца, легких и крови. Диагноз СД1 был установлен в соответствии с критериями Американской диабетической ассоциации. Анализ корреляции FBS и HbA1c с соотношением липидов и индивидуальными липидными индексами выполнен с помощью статистического пакета SPSS версии 20.0. Результаты. Средний возраст ± стандартное отклонение участников составил 15,71 ± 2,40 лет. Отмечалась значительная положительная корреляция между HbA1c, CHOL, TR, LDL-C и отношением LDL-C / HDL-C. Корреляция между HbA1c и HDL-C была отрицательной и статистически незначимой. Пациенты со значением HbA1c выше 7,0% имели значительно более высокие значения холестерина, холестерина LDL-C и отношения LDL-C / HDL-C по сравнению с пациентами со значением HbA1c до 7,0%. Выводы: HbA1c также может быть использован в качестве предиктора дислипидемии и, таким образом, ранняя диагностика дислипидемии может быть использована в качестве меры профилактики развития сердечно-сосудистых заболеваний у детей с СД1

The impact of the rehabilitation methods in children with type 1 diabetes mellitus - an update

Department of Pediatrics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, Institute of Mother and Child, Chisinau, Republic of Moldova, Department of Therapeutic Dentistry, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction. In children with Type 1 diabetes mellitus (T1DM) is necessary to implement prevention and treatment measures, aimed to reduce the risk of premature morbidity and mortality. Purpose. To evaluate the impact of rehabilitation methods of children with T1DM. Material and methods. The study was conducted between 22.07.2019 and 08.08.2019, on 34 children (21 boys, 13 girls), age range 3-15 years. Evaluated medical records (average of pre- and postprandial glucose, daily summary insulin dose, etc.). Treatment (aerohelio-thalassotherapy, sludge applications, laser therapy, massage, aeroion therapy, inhalations, alkaline mineral water) within the "Sergheevca" Children's Rehabilitation Center. Training in a cycle of lessons - "School of Diabetes". Food - according to physiological needs, with carbohydrate calculation. Performed at least 5 daily glucose with adjusting insulin doses (Glargine, Detemir, Aspart, Glulisin). Results. The total daily insulin dose (units/kg, see Fig.1) decreased by 18% in pediatric subjects with diabetes > 5 years (0.87→0.71) and 8% in those with 10 years, and under 10 years - 2% (0.85→) vs. - 9.7% (0.82→0.74)). In children > 10 years old there was a0.83 decrease of 13%, and in those under 10 years - 7%. The average blood glucose/24h, in children with diabetes > 5 years decreased by 5.6% (9.37→8.84 mmol/l), and in those with duration < 5 years - absent, and in the participants under 10 years a decrease of 8.5 % was noted (9.47→8.67 mmol/l), and in those over 10 years – absent. Conclusions. The rehabilitation methods have a positive impact for children with T1DM, expressed by a reduction of the total daily dose of insulin according to age, gender and duration of the disease

Modele de remodelare ventriculară stângă la copiii cu sindrom metabolic

Department of Pediatrics, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Department of Endocrinology, Nicolae Testemitanu State University of Medicine and Pharmacy, R. of Moldova, Department of Morpho-functional Sciences Pathophysiology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, RomaniaIntroduction. Pathological left ventricular (LV) remodeling in children with metabolic syndrome (MS) is associated with a significant increase in cardiometabolic risk. However, data regarding the prevalence of LV remodeling patterns in children with MS are limited. Material and methods. An observational analytical cohort study was conducted on 145 children. The diagnosis of MS was established according to the International Diabetes Federation (IDF) criteria. We analyzed the echocardiography, as well as clinical and paraclinical data. Participants were distributed, depending on LV mass index and relative wall thickness into four LV geometric patterns as recommended by American and European Society of Echocardiography: normal geometry, concentric left ventricular remodeling (cLVR), concentric left ventricular hypertrophy (cLVH), and eccentric left ventricular hypertrophy (eLVH). Results. The pathological remodeling patterns were distributed as follows: 62.1% (n=90) participants showed a normal LV geometry pattern, 27.6% (n=40) – cLVH, 5.5% (n=8) – cLVR and 4.8% (n=7) – eLVH. In terms of presence/absence of MS, 54.7% (n=29) participants from the research group showed a normal LV geometry pattern, 32.1% (n=17) – cLVH, 5.7% (n=3) – cLVR and 7.5% (n=4) – eLVH, whereas 66.3% (n=61) participants from the control group presented normal LV geometric appearance, 25% (n=23) – cLVH, 5.4% (n=5) – cLVR and 3.3% (n=3) – eLVR (χ2=0.52; p>0.05). Conclusions. Concentric left ventricular hypertrophy was the commonest LV geometric pattern among the subjects with metabolic syndrome. Concentric left ventricular remodeling and eccentric left ventricular hypertrophy were rare among the study population.Introducere. Remodelarea patologică a ventriculului stâng (VS) la copiii cu sindrom metabolic (SM) este asociată cu o creștere semnificativă a riscului cardiometabolic. Cu toate acestea, date privind prevalența paternelor de remodelare ale VS la copiii cu SM sunt limitate. Material și metode. Studiu analitic, observațional, de cohortă. Au fost incluși 145 de copii. Diagnosticul de SM a fost stabilit conform criteriilor Federației Internaționale de Diabet (FID). Am analizat datele clinice, paraclinice și ecocardiografice. Participanții au fost stratificați în patru tipare geometrice, folosind indicele de masă a VS și grosimea relativă a PPVS, așa cum recomandă Societatea Americană și Europeană de Ecocardiografie: geometrie normală VS, remodelare concentrică VS (RC VS), hipertrofie concentrică VS (HC VS) și hipertrofie excentrică VS (HE VS). Rezultate. Tipurile de remodelare patologică s-au repartizat în felul următor: 62.1% (n=90) participanți au prezentat aspect geometric normal al VS, la 27,6% (n=40) dintre ei s-a înregistrat HC VS, la 5,5% (n=8) participanți s-a atestat RC VS, iar 4,8% (n=7) din acest lot au prezentat HE VS. În funcție de prezența/absența SM, în lotul de bază, 54,7% (n=29) participanți au prezentat aspect geometric normal, la 32,1% (n=17) a fost înregistrată HC VS, 5.7% subiecți (n=3) au manifestat RC VS, iar 7,5% (n=4) au prezentat HE VS, iar în lotul de control – la 66,3% (n=61) participanți s-a atestat aspect geometric normal al VS, 25% (n=23) au prezentat HC VS, în 5,4% (n=5) cazuri s-a determinat RC VS, iar 3,3% (n=3) participanți au prezentat HE VS (χ2=0,52; p>0,05). Concluzii. Hipertrofia concentrică VS a fost cel mai frecvent model geometric al VS în rândul subiecților cu sindrom metabolic, iar remodelarea concentrică VS și hipertrofia excentrică VS au fost rar depistate în rândul populației din studiu