Key result
Fetal exposure to gestational diabetes mellitus was associated with impaired right ventricular contractility, specifically reduced fractional area change and fractional shortening (-1 SD, p < 0.05).
Why the study?
Hypertrophic cardiomyopathy in fetuses exposed to gestational diabetes mellitus is preceded by subclinical cardiac dysfunction, prompting evaluation of fetal cardiac geometry and contractility using two-dimensional speckle-tracking technology.
Does exposure to gestational diabetes mellitus impair fetal cardiac geometry and contractility compared to healthy pregnancies?
Observational (n=63)
Does exposure to gestational diabetes mellitus impair fetal cardiac geometry and contractility compared to healthy pregnancies?
Effect estimate: -1 SD
p-value: p=< 0.05
Fetuses exposed to gestational diabetes mellitus show impaired right ventricular contractility, particularly in mid and apical segments, detectable via speckle-tracking echocardiography.
Background: The most commonly known cardiac effect of gestational diabetes mellitus (GD) in the fetus is hypertrophic cardiomyopathy, but recent studies show that it is preceded by subclinical cardiac dysfunction. This study aimed to assess the effect of GD on fetal cardiac geometry and contractility by two-dimensional speckle-tracking technology. Methods: We performed a prospective observational study that included 33 pregnant patients with GD and 30 healthy individuals. For all fetuses, a four-chamber 3 s cine-loop was recorded and analyzed with Fetal Heart Quantification (FetalHQ®), a novel proprietary speckle-tracking software. The following cardiac indices were calculated: global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), and 24-segment end-diastolic diameter (EDD), fractional shortening (FS), and sphericity index (SI) for both ventricles. Demographic and cardiac differences between the two groups were analyzed, as well as intra-rater and inter-rater reliability. Results: There were significant changes in right ventricular FAC and FS for segments 4−24 in fetuses exposed to GD (−1 SD, p < 0.05). No significant differences were detected for GSI, GLS, EDD, or SI for either ventricle. Conclusions: Fetuses exposed to GD present impaired right ventricular contractility, especially in the mid and apical segments.
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Gireadă et al. (2022) conducted an observational in Gestational diabetes mellitus (n=63). Gestational diabetes mellitus vs. Healthy individuals was evaluated on Right ventricular fractional area change (FAC) and fractional shortening (FS) for segments 4-24 (-1 SD, p=< 0.05). Fetal exposure to gestational diabetes mellitus was associated with impaired right ventricular contractility, specifically reduced fractional area change and fractional shortening (-1 SD, p < 0.05).
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