Year: 2022
Type: article
Study design: Observational Study
Abstract: 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.
Source: Diabetes Care
DOI: 10.2337/dc22-0401
Authors: Sharmaine Thirunavukarasu, Faiza Ansari, Richard Cubbon, Karen Forbes, Chiara Bucciarelli-Ducci, David E. Newby, Marc R. Dweck, Oliver J. Rider, Ladislav Valkovič, Christopher T. Rodgers, Damian J. Tyler, Amrit Chowdhary, Nicholas Jex, Sindhoora Kotha, Lara Morley, Hui Xue, Peter Swoboda, Peter Kellman, John P. Greenwood, Sven Plein, Thomas Everett, Eleanor Scott, Eylem Levelt
Institutions: University of Leeds, National Health Service, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Imperial College London, University of Edinburgh, University of Oxford, Slovak Academy of Sciences, Institute of Measurement Science of the Slovak Academy of Sciences, University of Cambridge, National Institutes of Health, National Heart, Lung, and Blood Institute
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: G1048934281, G1729363023, G1951140721, G2574353342, Myocardial energy starvation and ketone metabolism in patients with type 2 diabetes, Metabolic magnetic resonance imaging across the human heart, G299057155, Does cellular insulin signalling modulate endogenous vascular repair and endothelial progenitor cell function via interaction with VEGF signalling?, Modification of calcification activity and 18F-fluoride positron emission tomography uptake in cardiovascular disease, Building an imaging toolbox for metabolic heart disease, G6499075845, Targeting beta-cell failure in lean patients with type 2 diabetes, Novel multi-nuclear magnetic resonance spectroscopy approaches for the sensitive and robust assessment of human cardiac energetics
OpenAlex ID: W4295424668