Left atrial shortening fraction in fetuses with and without myocardial hypertrophy in diabetic pregnancies

• Published in: Ultrasound in obstetrics & gynecology 2009-02, Vol.33 (2), p.182-187
• Main Authors: Zielinsky, P., Luchese, S., Manica, J. L., Piccoli, A. L., Nicoloso, L. H., Leite, M. F., Hagemann, L., Busato, A., Moraes, M. R.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiomegaly - diagnostic imaging; Cardiomegaly - physiopathology; Case-Control Studies; Cross-Sectional Studies; Diabetes Mellitus - diagnostic imaging; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Echocardiography; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; fetal diastolic function; Fetal Diseases - diagnostic imaging; Fetal Diseases - physiopathology; Fetal Heart - diagnostic imaging; Fetal Heart - physiopathology; fetal myocardial hypertrophy; Gynecology. Andrology. Obstetrics; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Humans; left atrial shortening fraction; maternal diabetes; Medical sciences; Myocardial Contraction; Pregnancy; Pregnancy in Diabetics; Ultrasonography, Prenatal; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0960-7692; 1469-0705
• DOI: 10.1002/uog.6154

Objective To test the hypothesis that, in diabetic pregnancies, left atrial shortening fraction (LASF) is decreased in fetuses with myocardial hypertrophy, compared to those without hypertrophy and to fetuses of non‐diabetic mothers. Methods Fetal echocardiography was performed in women with pre‐existing or gestational diabetes and in non‐diabetic controls between 25 weeks' gestation and term. LASF was calculated using the formula: (end‐systolic diameter—end‐diastolic diameter)/end‐systolic diameter, and data were compared between diabetic women with and without fetal myocardial hypertrophy and controls. Results The study population comprised 53 diabetic women and 45 controls. Out of the 53 fetuses of diabetic women, 14 had myocardial hypertrophy and 39 had normal septal thickness. Gestational age at the time of examination did not differ significantly between the control group and the two diabetic subgroups (P = 0.57). Fetuses with myocardial hypertrophy presented a mean ( ± SD) LASF of 0.32 ± 0.11, those without myocardial hypertrophy 0.46 ± 0.12, and those of normal mothers 0.53 ± 0.09 (P < 0.001). A significant inverse linear correlation was observed between LASF and septal thickness (r = − 0.51, P < 0.001). Conclusions In diabetic pregnancies, LASF is lower in fetuses with myocardial hypertrophy than it is in those without hypertrophy and in fetuses of non‐diabetic women, suggesting that LASF could be a useful alternative parameter in the assessment of fetal diastolic function. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.