Influence of gestational diabetes mellitus on subclinical myocardial dysfunction during pregnancy: A systematic review and meta-analysis

Sonaglioni, Andrea; Bordoni, Teresa; Naselli, Angelo; Nicolosi, Gian Luigi; Grasso, Enzo; Bianchi, Stefano; Ferrulli, Anna; Lombardo, Michele; Ambrosio, Giuseppe

doi:10.1016/j.ejogrb.2023.11.007

Cited by 4 publications

(3 citation statements)

References 63 publications

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“…Prior research has emphasized the diagnostic utility of LV GLS in identifying subclinical myocardial dysfunction within the obstetrical context, including conditions like pre-eclampsia and gestational diabetes mellitus. The results of this study reveal that term preeclamptic pregnant women, despite showing minimal functional alterations on conventional echocardiography, exhibit noteworthy subclinical myocardial changes when assessed through speckle tracking analysis [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Peripartum Cardiomyopathy: A Case Series Emphasizing the Significance of Left Ventricular Global Longitudinal Strain Imaging

Nalawade,

Chigulapalli,

Jadhav

et al. 2023

Cureus

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Peripartum cardiomyopathy (PPCM) poses diagnostic and management challenges, while left ventricular global longitudinal strain (LV GLS) provides crucial insights into myocardial function. This case series explores the significance of LV GLS imaging in diagnosing and managing PPCM. Three distinct cases of varying severity highlight the significance of LV-GLS in assessing myocardial function during the peripartum period. Each case exhibited varying degrees of cardiac impairment, with LV GLS serving as a sensitive indicator of dysfunction. Treatment response, closely monitored through LV GLS changes, emphasizes the importance of this imaging technique in evaluating therapy efficacy. The discussion underscores deviations from traditional management approaches, emphasizing the need for personalized strategies in PPCM. Nonetheless, the study's limitations stress the need for broader research to validate these findings across diverse populations and settings, as well as long-term follow-up of the patients who had persistence of abnormal global longitudinal strain values despite recovery of left ventricular ejection fraction.

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Section: Discussionmentioning

confidence: 99%

Peripartum Cardiomyopathy: A Case Series Emphasizing the Significance of Left Ventricular Global Longitudinal Strain Imaging

Nalawade,

Chigulapalli,

Jadhav

et al. 2023

Cureus

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“…Increasing researches suggest that maternal high-glucose environment can increase risk of insulin resistance in offspring [4,5] . Joseph conducted a demographic study and suggested that mothers with GDM would increase the risk of cardiovascular disease, obesity, and type 2 diabetes in their offspring [6,7] . Several studies have suggested that early diagnosis and timely treatment of GDM can signi cantly reduce the incidence of complications [8,9] .…”

Section: Introductionmentioning

confidence: 99%

Association of novel inflammatory markers with gestational diabetes mellitus in a representative U.S. sample: evidence from NHANES 2007-2018

Chen,

Zeng,

et al. 2024

Preprint

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Background Early detection of gestational diabetes mellitus (GDM) can lower the chance of occurrence. Recent years have seen a surge in research on novel inflammatory indicators, such as systemic immune inflammatory index (SII), lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Inflammation is linked to the pathophysiology of GDM and can be targeted for treatment. However, the relationship between GDM and these novel inflammatory markers is unclear. Methods We included participants with a diagnosis of GDM who were between the ages of 20 and 44, as well as complete blood counts from the US National Health and Nutrition Examination conducted between 2007 and 2018. SII, LMR, NLR, and PLR were among the novel inflammatory markers. First, we logarithmically transformed the exposure components to account for skewed distribution. We tested the relationship between GDM and novel inflammatory markers using a multiple logistic regression model and subgroup analyses to analyze the stability. And RCS curves were created to evaluate the non-linear connection. Results Following the inclusion of 3,722 women aged 20–44 years with GDM, multivariate logistic regression analysis revealed a positive correlation between log2-LMR and GDM (OR = 1.55, 95% CI = 1.20–2.01, p = 0.001), while negative correlations were observed between log2-SII, log2-PLR, and log2-NLR with GDM (OR = 0.84, 95% CI = 0.71–0.99, p = 0.04; OR = 0.73, 95% CI = 0.56–0.94, p = 0.01; OR = 0.65, 95% CI = 0.47–0.97, p = 0.03), and the correlation remained significant even after controlling for all confounders. Correlations were consistently shown by subgroup analyses. When the log2-LMR value was less than 1.79, the risk of GDM reduced with rising log2-LMR, and this tendency was reversed when larger than 1.79. Conclusions Elevated levels of new inflammatory markers are correlated with an increased risk of GDM and may offer clinicians with information to screen for GDM and identify GDM therapeutic targets. Further studies are required to investigate the causal relationship between the new inflammatory markers and GDM.

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“…Additionally, GDM has been associated with hypertrophic cardiomyopathy, pericardial effusion, and bradycardia, even beyond structural malformations. However, it is widely thought that cardiac function impairment during fetal development may precede myocardial thickening ( Sonaglioni et al, 2023 ). Therefore, examining both fetal cardiac morphology and function is crucial in GDM patients.…”

Section: Introductionmentioning

confidence: 99%

Quantifying fetal heart health in gestational diabetes: a new approach with fetal heart quantification technology

Zhang,

Fu,

Zhao

et al. 2024

Front. Pharmacol.

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ObjectiveThis study aimed to assess the impact of gestational diabetes mellitus (GDM) on fetal heart structure and function using a technique called fetal heart quantification (Fetal HQ), with a focus on mitochondrial dynamics, which employs advanced imaging technology for comprehensive analysis.MethodsA total of 180 fetuses with normal heart structures, aged 24–40 weeks of gestation, were examined. A 2–3 s cine loop in the standard four-chamber oblique view was captured and analyzed using the speckle-tracking technique with Fetal HQ. Various echocardiographic parameters were evaluated, including four-chamber view (4CV), global spherical index (GSI), global longitudinal strain (GLS), 24-segment spherical index (SI), ventricular fractional area change (FAC), cardiac output (CO), and stroke volume (SV). These parameters were compared between the GDM group and the control group during two gestational periods: 24+0 to 28+0 weeks and 28+1 to 40+1 weeks. Statistical analysis was performed using independent samples t-tests and Mann-Whitney U tests to identify significant differences.ResultsTwenty fetuses from mothers with GDM and 40 from the control group were recruited at 24+0 to 28+0 weeks. At 28+1 to 40+1 weeks, 40 fetuses from mothers with GDM and 80 from the control group were recruited. The fetal left ventricular global longitudinal function was similar between the GDM and control groups. However, compared to the controls, right ventricular function in the GDM group was lower only at 28+1 to 40+1 weeks. In the GDM group, the global spherical index (GSI) was lower than in the control group at 28+1 to 40+1 weeks (1.175 vs. 1.22; p = 0.001). There were significant decreases in ventricular FAC (38.74% vs. 42.83%; p < 0.0001) and 4CV GLS for the right ventricle (−22.27% vs. −26.31%; p = 0.005) at 28+1 to 40+1 weeks.ConclusionOur findings suggest that GDM is associated with decreased right ventricular function in the fetal heart, particularly during the later stages of pregnancy (28+1 to 40+1 weeks), compared to fetuses from healthy pregnancies. The Fetal HQ technique represents a valuable tool for evaluating the structure and function of fetal hearts affected by GDM during the advanced stages of pregnancy.

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Influence of gestational diabetes mellitus on subclinical myocardial dysfunction during pregnancy: A systematic review and meta-analysis

Cited by 4 publications

References 63 publications

Peripartum Cardiomyopathy: A Case Series Emphasizing the Significance of Left Ventricular Global Longitudinal Strain Imaging

Peripartum Cardiomyopathy: A Case Series Emphasizing the Significance of Left Ventricular Global Longitudinal Strain Imaging

Association of novel inflammatory markers with gestational diabetes mellitus in a representative U.S. sample: evidence from NHANES 2007-2018

Quantifying fetal heart health in gestational diabetes: a new approach with fetal heart quantification technology

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