Effect of well-controlled gestational diabetes on left ventricular diastolic dysfunction in neonates.

Background: There are some evidences supporting the relation between gestational diabetes mellitus (GDM) and diastolic dysfunction. The aim of our study was to investigate the effect of well-controlled GDM on morphological and functional myocardium.Materials and Methods: We designed a prospective cr...

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Publicado en:Journal of Maternal-Fetal & Neonatal Medicine Vol. 32; no. 13; pp. 2101 - 2107
Autores principales: Ghandi, Yazdan, Habibi, Danial, Nasri, Khadijeh, Alinejad, Saeed, Taherahmad, Hassan, Arjmand Shabestari, Ali, Nematinejad, Ali
Formato: Journal Article
Publicado: Taylor & Francis Ltd Jul2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2019
      vid: 32
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      pub: Taylor & Francis Ltd
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        10.1080/14767058.2018.1425832
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        135672160
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        atl: Effect of well-controlled gestational diabetes on left ventricular diastolic dysfunction in neonates.
      aug:
        au:
          Ghandi, Yazdan
          Habibi, Danial
          Nasri, Khadijeh
          Alinejad, Saeed
          Taherahmad, Hassan
          Arjmand Shabestari, Ali
          Nematinejad, Ali
        affil: Amirkabir Hospital, Department of Pediatric Cardiology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
      sug:
        subj:
          Ventricular Dysfunction, Left Etiology
          Diabetes Mellitus, Gestational Diet Therapy
          Diabetes Mellitus, Gestational Drug Therapy
          Heart Hypertrophy Etiology
          Insulin
          Cross Sectional Studies
          Ventricular Dysfunction, Left
          Metformin
          Infant, Newborn
          Echocardiography, Doppler, Pulsed
          Ventricular Dysfunction, Left Physiopathology
          Iran
          Male
          Pregnancy
          Adult
          Heart Hypertrophy Physiopathology
          Female
          Prospective Studies
          Heart Hypertrophy
          Case Control Studies
          Hypoglycemic Agents
          Infant, Newborn: birth-1 month
          Adult: 19-44 years
          Male
          Female
      ab: Background: There are some evidences supporting the relation between gestational diabetes mellitus (GDM) and diastolic dysfunction. The aim of our study was to investigate the effect of well-controlled GDM on morphological and functional myocardium.Materials and Methods: We designed a prospective cross-sectional study to evaluate left ventricular (LV) diastolic function of 60 neonates born from mothers with well-controlled GDM (case group) on days of 3-5 after birth. The infants of diabetic mothers (IDM) group were divided into two groups: diabetic mothers treated only with diet (class A) and group of mothers on medical therapy by insulin or metformin (class B). Traditional echocardiography and pulsed-wave Doppler (PWD), tissue Doppler imaging (TDI) were performed for all the neonates.Results: The study group consisted of 60 neonates as males (M) = 32, (0.53%) and females (F) = 28, (0.46%). Using M-mode echocardiography, interventricular septum thickness (IVS), and LV mass were significantly higher in IDM than control group (p = .0001). The PWD showed both a significantly more peak mitral flow at early diastolic wave (E) and an early filling deceleration time (E-DT) (p = .0001). Tissue Doppler echocardiography parameters A' (cm/s) (p = .0001), E' (cm/s) (p = .002), and E'/A' ratio (p = .0001), left ventricular myocardial performance index (LVMPI), and isovolumetric relaxation time (IVRT) were outstandingly different between the two groups (p = .0001, respectively). Evaluating the GDM group mothers of class A and class B, no significant difference was noted in PWD or TDI parameters compared with the healthy ones.Conclusions: It seems that neonates of mothers with well-controlled GDM are still at increased risk of cardiac hypertrophy, subclinical diastolic dysfunction, and impaired left ventricular relaxation. This can be interpreted that focusing only on glycemic control is not enough to prevent cardiac dysfunction.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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