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  • Clinical Research Article
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Impaired myocardial deformation persists at 2 years in offspring of mothers with diabetes mellitus

Pediatric Research volume 94, pages 996–1002 (2023)Cite this article

Abstract

Background

A diabetic intrauterine environment has been proposed as a potential etiological mechanism for in utero programming of cardiac disease, and is associated with impaired fetal cardiac function. We aimed to assess cardiac function in offspring of mothers with diabetes mellitus (ODM) and determine whether fetal cardiac abnormalities persist during follow-up.

Methods

Longitudinal observational study to evaluate and compare myocardial function in 40 ODM to age-matched control offspring (CO). Myocardial deformation was measured using speckle-tracking echocardiography (STE).

Results

Significant differences were detected in global longitudinal strain (−20.9 ± 3.1 vs. −23.6 ± 2.2%; p = 0.001), global circumferential strain (−24.4 ± 3.9 vs. −26.9 ± 2.7%; p = 0.017), average radial strain (29.0 ± 9.8 vs. 37.1 ± 7.2%; p = 0.003), average longitudinal systolic strain rate (−1.24 ± 0.25/s vs. −1.47 ± 0.30/s; p = 0.011) and average circumferential systolic strain rate (−1.56 ± 0.37/s vs. −1.84 ± 0.37/s; p = 0.013) in comparison to CO up to 2 years of follow-up. Minimal differences were observed within ODM over the 2-year period.

Conclusion

Impaired cardiac function in ODM persists during 2 years follow-up. Functional cardiac assessment might therefore be useful to detect these unfavorable changes, independent of screening for congenital heart disease or hypertrophic cardiomyopathy in this population.

IMPACT

  • We demonstrate persistence of subclinical myocardial deformation abnormalities in offspring of mothers with diabetes mellitus from fetal life to early childhood years.

  • These results extend the cellular observations in basic and translational research of developmental programming into the clinical realm.

  • Persistence of subclinical myocardial deformation abnormalities may shed light on the known incidence of early cardiovascular disease in offspring of mother with diabetes.

  • Cardiac myocardial strain assessment can be useful to detect these abnormalities, independent of screening for congenital heart disease or hypertrophic cardiomyopathy in this population.

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Fig. 1: Parameters of myocardial deformation in ODM compared to age-matched CO.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Ling Li (LL), MD, PhD from University of Nebraska Medical Center, Omaha, NE and Daisy Gonzalez (DG), RDCS from White Plains Hospital, NY for their efforts in data measurements and data collection.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Xander Jacquemyn was supported by the Belgian American Educational Foundation.

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Authors and Affiliations

  1. Helen B. Taussig Heart Center, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA

    Xander Jacquemyn, Shelby Kutty & William J. Ravekes

  2. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

    Xander Jacquemyn

  3. Cohen Children’s Heart Center, Cohen Children’s Medical Center, Donald and Barbara Zucker School of Medicine, New Hyde Park, New York, NY, USA

    Preeta Dhanantwari & Aparna Kulkarni

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Contributions

X.J.: Concept/design, data collection, data interpretation, drafting article, critical revision of article, and approval of article. S.K.: Concept/design, data interpretation, drafting article, critical revision of article, and approval of article. P.D.: Data interpretation, drafting article, critical revision of article, and approval of article. W.J.R.: Data interpretation, drafting article, critical revision of article, and approval of article. A.K.: Concept/design, data collection, data interpretation, drafting article, critical revision of article, and approval of article.

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Correspondence to Aparna Kulkarni.

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All participants included in this study gave informed consent for inclusion at the time of enrollment and at follow-up at 1- and 2 years respectively.

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Jacquemyn, X., Kutty, S., Dhanantwari, P. et al. Impaired myocardial deformation persists at 2 years in offspring of mothers with diabetes mellitus. Pediatr Res 94, 996–1002 (2023). https://doi.org/10.1038/s41390-023-02566-6

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