Evaluation of the regional ventricular systolic function by two-dimensional strain echocardiography in gestational diabetes mellitus (GDM) fetuses with good glycemic control

Abstract

OBJECTIVE: The aim is to quantitatively assess regional ventricular systolic function by two-dimensional strain (2DS) echocardiography in gestational diabetes mellitus (GDM) fetuses with good glycemic control. METHODS: We studied 60 consecutive normal fetuses and 35 fetuses of GDM mothers with good glycemic control by echocardiography. M-mode and two-dimensional echocardiography were used to measure ejection fraction and wall dimensions of left ventricle and right ventricle. Both left and right ventricle peak systolic myocardial strain values were obtained by 2DS echocardiography. RESULTS: Compared with normal fetuses, the thickness of the interventricular septum (IVS) and the thickness of right ventricular wall were significantly increased in GDM fetuses (p < 0.05). Compared with those of normal fetuses, the peak systolic myocardial strain decreased significantly in the apical segments of the IVS and the apical segments of the left ventricular lateral wall in GDM fetuses (p < 0.05), as well as the apical and middle segments of right ventricular wall in GDM fetuses (p < 0.05). Peak negative 2DS values in 60 normal fetuses increased with the gestational age, showing a significant linear correlation(r = -0.625, p < 0.001). The average ventricular strain was not correlated to ventricular wall thickness (r = 0.127, p = 0.394). CONCLUSIONS: 2DS is a feasible approach to assess regional ventricular systolic function in the fetal hearts and it can be used to examine cardiac systolic function in GDM fetuses with good glycemic control.