Association of Cardiac Structural and Functional Abnormalities With Gestational Diabetes

Abstract

Introduction: Pregnancy leads to changes in the cardiovascular system. Gestational diabetes relates to maternal and fetus later development of chronic cardiovascular diseases. We perform an exploratory analysis to assess the prevalence of cardiac structural and functional abnormalities in pregnant women with gestational diabetes. Methods: We enrolled 20 consecutive pregnant women with gestational diabetes and 30 healthy pregnant women as controls. Participants with age less than 18 years, previous gestational diabetes, hypertension, cardiac diseases, lung diseases, or medications other than vitamins were excluded. A comprehensive echocardiography protocol was performed in all participants, including 2D views, M-mode technique, flow assessment, and tissue Doppler imaging to acquire cardiac structural and functional parameters. A cross-sectional analysis was performed to assess relations of gestational diabetes with echocardiography-derived parameters. Results: Women with gestational diabetes had higher weight compared to normal pregnant participants, but the cardiovascular risk profile was similar in both groups. LV mass index was significantly higher in women with gestational diabetes when compared to normal pregnant controls, but the other echocardiography-derived parameters were similar in both groups. Gestational diabetes had significant predictive power on higher values of LV mass index, consistent after adjustment for anthropometrics, risk factors, and gynecological history. Conclusion: The presence of gestational diabetes has a consistent independent relation with higher values of LV mass index, but not with other measurements of LV systolic and diastolic function. Myocardial hypertrophy appears to be an early marker of gestational diabetes-related cardiac injury.