Journal article
Maternal cardiac changes in women with obesity and gestational diabetes mellitus
- Abstract:
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OBJECTIVE
We investigated if women with gestational diabetes mellitus (GDM) in the third trimester of pregnancy exhibit adverse cardiac alterations in myocardial energetics, function, or tissue characteristics.
RESEARCH DESIGN AND METHODS
Thirty-eight healthy, pregnant women and 30 women with GDM were recruited. Participants underwent phosphorus MRS and cardiovascular magnetic resonance for assessment of myocardial energetics (phosphocreatine [PCr] to ATP ratio), tissue characteristics, biventricular volumes and ejection fractions, left ventricular (LV) mass, global longitudinal shortening (GLS), and mitral in-flow E-wave to A-wave ratio.
RESULTS
Participants were matched for age, gestational age, and ethnicity. The following data are reported as mean ± SD. The women with GDM had higher BMI (27 ± 4 vs. 33 ± 5 kg/m2; P = 0.0001) and systolic (115 ± 11 vs. 121 ± 13 mmHg; P = 0.04) and diastolic (72 ± 7 vs. 76 ± 9 mmHg; P = 0.04) blood pressures. There was no difference in N-terminal pro-brain natriuretic peptide concentrations between the groups. The women with GDM had lower myocardial PCr to ATP ratio (2.2 ± 0.3 vs. 1.9 ± 0.4; P < 0.0001), accompanied by lower LV end-diastolic volumes (76 ± 12 vs. 67 ± 11 mL/m2; P = 0.002) and higher LV mass (90 ± 13 vs. 103 ± 18 g; P = 0.001). Although ventricular ejection fractions were similar, the GLS was reduced in women with GDM (−20% ± 3% vs. −18% ± 3%; P = 0.008).
CONCLUSIONS
Despite no prior diagnosis of diabetes, women with obesity and GDM manifest impaired myocardial contractility and higher LV mass, associated with reductions in myocardial energetics in late pregnancy compared with lean women with healthy pregnancy. These findings may aid our understanding of the long-term cardiovascular risks associated with GDM.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 5.4MB, Terms of use)
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- Publisher copy:
- 10.2337/dc22-0401
Authors
- Publisher:
- American Diabetes Association
- Journal:
- Diabetes Care More from this journal
- Volume:
- 45
- Issue:
- 12
- Pages:
- 3007-3015
- Publication date:
- 2022-09-12
- Acceptance date:
- 2022-07-25
- DOI:
- EISSN:
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1935-5548
- ISSN:
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0149-5992
- Pmid:
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36099225
- Language:
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English
- Keywords:
- Pubs id:
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1279347
- Local pid:
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pubs:1279347
- Deposit date:
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2022-12-20
Terms of use
- Copyright holder:
- American Diabetes Association
- Copyright date:
- 2022
- Rights statement:
- © 2022 by the American Diabetes Association. This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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