Assessment of Cardiac Functions in Fetuses of Gestational Diabetic Mothers

Autor: Feyza Aysenur Pac, Mehmet Burhan Oflaz, İbrahim Ece, Ayse Esin Kibar, Sevket Balli, Omer Kandemir
Přispěvatelé: [Balli, Sevket] Balikesir Ataturk Hosp, Dept Pediat Cardiol, Balikesir, Turkey -- [Pac, Feyza Aysenur] Turkiye Yuksek Ihtisas Training & Educ Hosp, Dept Pediat Cardiol, Ankara, Turkey -- [Ece, Ibrahim] Yuzuncu Yil Univ, Dept Pediat Cardiol, Fac Med, Van, Turkey -- [Oflaz, Mehmet Burhan] Cumhuriyet Univ, Dept Pediat Cardiol, Fac Med, Sivas, Turkey -- [Kibar, Ayse Esin] Mersin Childrens Hosp, Dept Pediat Cardiol, Mersin, Turkey -- [Kandemir, Omer] Zubeyde Hanim Obstet & Childrens Hosp, Dept Obstet & Gynecol, Ankara, Turkey, Oflaz, Mehmet Burhan -- 0000-0003-1515-4654
Rok vydání: 2013
Předmět:
Zdroj: Pediatric Cardiology. 35:30-37
ISSN: 1432-1971
0172-0643
DOI: 10.1007/s00246-013-0734-0
Popis: WOS: 000329374800005
PubMed ID: 23780554
We investigated cardiac function in 67 fetuses of gestational diabetic mothers (FGDMs) and 122 fetuses of healthy mothers between 24 and 36 weeks of gestation. Cardiac functions were evaluated by M-mode, pulsed-wave, and tissue Doppler echocardiography. Fetal echocardiograms were performed at 24, 28, 32, and 36 weeks of gestation. Glycated hemoglobin (HbA1c) levels were obtained from all pregnant women at 24 weeks of gestation. The mean age of diabetic pregnant women was significantly greater than that of controls. Serum HbA1c values of both groups were within normal limits, but they were significantly greater in the diabetic group (p = 0.003). The increase in peak aortic and pulmonary artery velocities were greater in FGDM (p < 0.001). No pathological interventricular septal (IVS) hypertrophy was observed. There was a significant increase in IVS thickness in FGDM compared with controls, which was more prominent at the end of the third trimester (p < 0.001). During the course of pregnancy, mitral E-wave (p < 0.001), A-wave (p = 0.007), tricuspid E-wave (p < 0.001) and A-wave (p = 0.002) velocities were greater in FGDM. The increases in mitral E/A and tricuspid E/A ratios were lower in FGDM with advancing gestation. The E (a)-wave (p = 0.02), A (a)-wave (p = 0.04), and S (a)-wave (p < 0.001) velocities of the right-ventricular (RV) free wall and the E (a) (p = 0.02) and A (a) (p = 0.01) velocities of the left-ventricle (LV) posterior wall were greater in FGDM during the course of pregnancy. The E (a)/A (a) ratio of the RV posterior wall was greater in FGDM with advancing gestation (p < 0.03). LV and RV E/E (a) ratios were similar in both groups. The LV myocardial performance index measured by pulsed-wave Doppler was greater in FGDM (p < 0.001). We detected diastolic dysfunction in FGDM. The data suggest that gestational diabetes mellitus may impair ventricular diastolic functions without causing pathological fetal myocardial hypertrophy. We detected subclinical diastolic dysfunction using both pulsed-wave and tissue Doppler imaging in FGDM.
Databáze: OpenAIRE
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