Author + information
- Victor Do,
- Tina Ojala,
- Timothy Colen,
- Silvia Goncalvez-Alvarez,
- Sandra Davidge,
- Jesus Serrano-Lomelin and
- Lisa Hornberger
Background: Infants of diabetic mothers (IDMs) develop left ventricular(LV) hypertrophy and mild diastolic dysfunction prenatally, and are at increased risk of adult cardiovascular disease(CVD). Whether fetal changes truly resolve or persist, contributing to long-term CVD has not been explored. The aims of our study were to determine if IDMs have myocardial hypertrophy and diastolic dysfunction in late infancy, have increased aortic stiffness, and if cardiovascular pathology of IDMs is associated with worse maternal glycemic control.
Methods: We longitudinally investigated myocardial and vascular health by echocardiography in offspring of pregestational DM pregnancies both prenatally (3 each, 20-40 weeks) and in infancy (2-6 weeks & 6-12 months). We compared LV posterior(LVPW) and septal(IVS) wall thickness, systolic and diastolic function and aortic stiffness (pulse wave velocity, PWV) between IDMs and pre and postnatal age-matched controls from healthy pregnancies, and collected maternal A1c values.
Results: 36 IDMs and 36 controls were prospectively recruited. Increased LVPW and IVS was present in DM fetuses from the midtrimester that persisted through both early and late infancy (p<0.01, all ages). Although increased LV Tei index was present in late gestation in IDMs, and mild diastolic pathology in early infancy, by late infancy LV function was comparable to controls. PWV was increased in late infancy in IDMs (3.7+/-1.2 vs 2.2+/-0.5m/s, p <0.01) which correlated with LVPW and IVS (R2 0.82 & 0.87, respectively, p <0.05). Late infancy PWV also correlated with 3rd trimester A1c (R2 = 0.83, p<0.05), but LVPW and IVS did not. Systolic and diastolic blood pressure did not differ between groups.
Conclusions: IDMs display persistence of LV hypertrophy through late infancy. Aortic stiffness is increased in IDMs in late infancy which relates to late gestation maternal glycemic control.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Heart Disease: New Diagnostic Approaches in Congenital Heart Disease
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1231-020
- 2017 American College of Cardiology Foundation