Non-Invasive Myocardial Work Indices in Infants Born to Mothers With Diabetes in Pregnancy

• Published in: Circulation Journal Vol. 87; no. 8; pp. 1095 - 1102
• Main Authors: Iwashima, Satoru, Yanase, Yuma, Takahashi, Ken, Murakami, Yusuke, Tanaka, Aki, Hiyoshi, Yasuo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.07.2023
• Subjects: Cardiac performance; Diabetes, Gestational - diagnosis; Diabetic cardiomyopathy; Female; Gestational diabetes; Glucose Tolerance Test; Glycated Hemoglobin; Humans; Infant; Infant complications; Mothers; Pregnancy; Retrospective Studies; Diabetic cardiomyopathy; Cardiac performance; Gestational diabetes; Infant complications
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-22-0804

Background: This study used echocardiography to investigate non-invasive myocardial work (MCW) indices in infants born to mothers with diabetes mellitus (DM) in pregnancy (gestational DM: GDM), including those diagnosed under novel classification criteria and those with pre-existing DM.Methods and Results: This single-centered, retrospective study included 25 infants born to mothers with GDM (termed “infant with GDM”), which was diagnosed by oral glucose tolerance test results during pregnancy or the presence of diabetes before the current pregnancy. We evaluated the relationship between the infant’s MCW, such as global constructive work (GCW), global work index (GWI), global work efficiency (GWE), and global wasted work (GWW), and the mother’s GDM maximal HbA1c during pregnancy. HbA1c level in GDM significantly negatively correlated with GWI* (r=−0.565) and GCW* (r=−0.641). In infants with GDM, GWI and GCW were significantly higher with <6.5% HbA1c than in those with >6.5% HbA1c GDM; however, the specific-layer global longitudinal strain analyses did not show any significant differences between the groups. The pressure-strain loop in infants with >6.5% HbA1c in GDM tended to be smaller than in those infants with <6.5% HbA1c GDM.Conclusions: The hyperglycemic environment of GDM leads to impaired MCW in the infants. MCW is useful for screening for cardiac illnesses among infants with GDM. Appropriate maternal blood glucose management while maintaining HbA1c <6.5% might be beneficial for the cardiac performance of infants with GDM.