Evaluation of left ventricular systolic function in neonates born to mothers with gestational diabetes mel-litus by pressure strain ring
Su Lili
Cao Xufeng
Niu Haiyan
Sui Chao
Liu Huifang
Abstract：Objective To evaluate left ventricular systolic function in neonates born to mothers with gestational diabetes mellitus(GDM)by non-invasive left ventricular pressure-strain loop(LVPSL).Methods Sixty-one neonates born to mothers with GDM treated at the Seventh Medical Center of the General Hospital of the People's Liberation Army of China were collected as the case group,and thirty healthy neonates born to pregnant women without pregnancy complications were collected as the control group.According to the glycosylated hemoglobin(HbA1c)level of GDM women,the case group was further divided into HbA1c≤6.5%(n=34)and HbA1c＞6.5%(n=27).Echocardiography was performed within 24～48 hours after birth.Global longitudinal strain(GLS)was obtained through the speckle tracking technology.PSL technology was used to obtain left ventricular myocardial work parameters,including global myocardial work index(GWI),global constructive work(GCW),global wasted work(GWW),and global myocardial work efficiency(GWE).The general clinical data,conventional echocardiography parameters,and myocardial work parameters of the left ventricle among three groups were compared,and the correlation between the left ventricular myocardial work parameters of neonates born to mothers with GDM and their mother's HbA1c was analyzed.Results Compared with the control group,the weight increased in the HbA1c≤6.5%group and HbA1c＞6.5%group(P＜0.05).Comparison of the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular posterior wall thickness at end-diastole(LVPWD),and left ventricular ejection fraction(LVEF)among the three groups showed no statistically significant differences(P＞0.05).Compared to the control group,both the HbA1c≤6.5%group and the HbA1c＞6.5%group showed an increase in the interventricular septal thickness at end-diastole(IVSD),with statistically significant differences(P＜0.05).However,there was no statistically significant difference in IVSD between the HbA1c≤6.5%group and the HbA1c＞6.5%group(P=0.356).Compared with the control group,the HbA1c≤6.5%group and the HbA1c＞6.5%grouphad significant reductionsin GLS,GWI,and GCW,and the differences were statistically significant(P＜0.05).The GLS,GWI,and GCW of the HbA1c＞6.5%group were significantly lower than those of the HbA1c≤6.5%group(P＜0.05).There was no statistically significant difference in GWW and GWE among the three groups(P＞0.05).The GLS of neonates born to mothers with GDM is positively correlated with their mother's HbA1c(r=0.687,P＜0.001),while the GWI and GCW of neonates born to mothers with GDM are negatively correlated with their mother's HbA1c(r=-0.643,P＜0.001;r=-0.627,P＜0.001).There is no correlation between GWW and GWE of neonates and their mother's HbA1c(P＞0.05).Conclusion Non invasive LVPSL can quantitatively evaluate the changes in left ventricular myocardial work in born to mothers with GDM and it can early and sensitively reflect of left ventricular systolic dysfunction in neonates born to mothers with GDM GDM.Moreover,the worse the blood glucose control level of pregnant women,the more severe the left ventricular systolic dysfunction in neonates.
Keywords：Pressure-strain loopsGestational diabetes mellitusNeonatesLeft ventricular systolic function
Publication Date：2025-01-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 115-119 )