Assessment of structural cardiac abnormalities and diastolic function in women with gestational diabetes mellitus

• Published in: Diabetes & vascular disease research 2015-05, Vol.12 (3), p.175-180
• Main Authors: Oliveira, Alexandra P, Calderon, Iracema MP, Costa, Roberto AA, Roscani, Meliza G, Magalhães, Claudia G, Borges, Vera TM
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers - blood; Blood Glucose - metabolism; Body Mass Index; Case-Control Studies; Diabetes, Gestational - blood; Diabetes, Gestational - diagnosis; Diastole; Echocardiography, Doppler; Female; Gestational Age; Glucose Tolerance Test; Humans; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Pregnancy; Risk Factors; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left; Young Adult
• ISSN: 1479-1641; 1752-8984
• DOI: 10.1177/1479164114563302

Background: The main manifestation of hyperglycaemia during pregnancy is gestational diabetes mellitus. It can herald diabetes mellitus type 2 and its deleterious long-term effects, such as hypertension and cardiovascular disease. The aim of this study was to assess diastolic function in women with gestational diabetes mellitus, one of the first signs of future cardiovascular disease. Methods: A total of 21 women with gestational diabetes mellitus and 23 healthy pregnant women (control group) between 34 and 37 weeks of gestation underwent echocardiographic assessment. The diagnosis of gestational diabetes mellitus was made in agreement with the American Diabetes Association criteria. Echocardiographic images obtained were analysed according to the criteria of the American Society of Echocardiography. Data were analysed using Pearson correlation coefficient, analysis of variance and Student’s t-test. Results: Women with gestational diabetes mellitus had higher posterior wall and interventricular septum thickness, increased left ventricular mass and left ventricular mass index, lower early diastolic annular velocity and early diastolic annular velocity/late diastolic annular velocity ratio. There was a positive correlation between left ventricular mass index and fasting glucose and pregnancy body mass index. Conclusion: Patients with gestational diabetes mellitus seem to have a different diastolic profile as well as a mildly dysfunctional pattern on echocardiogram, which may show a need for greater glycaemic control.