Abstract
Background
The purpose of our study was to quantify the fetal myocardial function in pregnant women with diabetic diseases (FDM) and in normal controls (FC) using speckle tracking echocardiography (STE).
Methods
In this prospective study, the myocardial strain and dyssynchrony were analyzed using STE in a transversal four-chamber view in 180 fetuses (53 FDM, 127 FC) between 19 and 39 weeks of gestation. The measurements of the global and segmental longitudinal strain of both chambers (2C) and of the single left chamber (1C) were executed offline via QLab 10.5 (Philips Medical Systems, Andover, MA, USA). We assessed dyssynchrony as the time difference between peaks in strain in the mid segments of both chambers (interventricular dyssynchrony, 2C_DYS) and of the single left chamber (intraventricular dyssynchrony, 1C_DYS).
Results
Measurements were feasible with a high median frame rate of 199 frames/s (1st quartile: 174, 3rd quartile: 199). The global and segmental myocardial longitudinal strain of 2C and 1C were decreased and 2C_DYS and 1C_DYS were increased in pregnancies with diabetes compared to normal controls.
Conclusion
Our study demonstrates that fetal hearts affected by maternal diabetes mellitus (DM) show low myocardial strain values and high interventricular dyssynchrony. Two-chamber interventricular dyssynchrony has the potential to become a diagnostic marker for DM.
Acknowledgments
We thank everyone who voluntarily dedicated their time and effort.
Author contributions: N. Rolf: Data collection, data management, data analysis, manuscript writing. L. Kerschke: Data analysis, manuscript editing. J. Braun: Data collection, manuscript editing. M.K. Falkenberg: Data collection, manuscript editing. K. Hammer: Data collection, manuscript editing. H.A. Köster: Manuscript editing. M. Möllers: Data collection, manuscript editing. K. Oelmeier de Murcia: Data collection, manuscript editing. W. Klockenbusch: Manuscript editing. R. Schmitz: Conceptualization, data collection, manuscript editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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