Evaluation of Left Ventricular Diastolic Function in South Indian Pregnant women with Gestational Diabetes Mellitus

Abstract

Introduction:Normal pregnancy alters cardiac function and is also a diabetogenic state. Indian pregnant women are at high risk of developing gestational diabetes mellitus (GDM). Studies have shown that GDM is associated with subtle changes in cardiac function .The objective of this study was to evaluate the left ventricular diastolic function in pregnancies with GDM in South Indian women and compare them with normal pregnancies in various trimesters of pregnancy. Methods: This was an observational cross-sectional study on 97 normal pregnant women and 27 women with GDM in the three trimesters of pregnancy. Normal non-pregnant healthy women (NW) were taken as control. Clinical examination, a 12-lead electrocardiogram, M Mode 2-D Echocardiography, pulsed wave Doppler and Tissue Doppler Imaging (TDI) were done. Peak mitral flow velocities in early diastole (E) and late,at atrial contraction (A) and the E/A ratio, early diastolic annular velocity (Eꞌ), late diastolic annular velocity (Aꞌ) and Eꞌ/Aꞌ ratio were determined. The data are represented as mean + SEM and analysed by two-way analysis of variance and Bonferroni‘t’ test for post-hoc multiple comparisons. Results: The mean posterior wall thickness during end-diastole (PWd) was increased in GDM compared to NW (30.2 %) and NP (9.9 %). GDM showed significantly lesser value of E/A ratio compared to NP (P = 0.035). GDM also showed on an average 29.4 % decrease in Eꞌ/Aꞌ ratio compared to normal pregnancy. Conclusions:Echocardiography can be useful in women who develop GDM for early detection of alterations in cardiac function to prevent future cardiovascular events.

Imprint

Rohini, G., Meenakshi. K., Vijayaraghavan. R., SiriMadhuri. T.. Evaluation of Left Ventricular Diastolic Function in South Indian Pregnant women with Gestational Diabetes Mellitus. Cardiometry; Issue 26; February 2023; p.914-922; DOI: 10.18137/cardiometry.2023.26.914922; Available from: https://www.cardiometry.net/issues/no26-february-2023/evaluation-left-ventricular-diastolic