Abstract 9100: Two-Dimensional Speckle Tracking Echocardiography in Assessing the Subclinical Myocardial Dysfunction in Patients With Gestational Diabetes Mellitus

Abstract

Introduction and Hypothesis: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance first diagnosed during pregnancy, which may increase the risk of incident cardiovascular disease. Asymptomatic subclinical myocardial dysfunction already exists before the GDM diagnosis. In this study, we hypothesize that the two-dimensional speckle tracking echocardiography (2D-STE) may identify the subclinical impairment of GDM on the maternal left ventricular function. Methods: We prospectively enrolled 47 women with GDM and 62 healthy pregnant women (control group) at their 24~28 weeks of gestation who underwent transthoracic echocardiography (TTE). GDM diagnosis was in agreement with the IADPSG criteria. TTE was performed according to the recommendations of the American Society of Echocardiography. Conventional and 2D-STE parameters were compared between the two groups. Results: Age, gestational weeks, heart rate, and conventional echocardiographic parameters had no difference between the two groups. LV global longitudinal strain (LV-GLS) was lower in GDM (18.14 ± 2.53 vs. 22.36 ± 6.33, p< 0.001). LA reservoir and conduit phasic strain also decreased in patients with GDM (32.71 ± 6.64 vs. 38.00 ± 7.06, 20.41 ± 5.69 vs. 25.56 ± 5.73, p< 0.001). However, there was no significant difference regarding LA contractile function between the two groups. In multivariate regression analysis, the LV-GLS and LA conduit strain independently associated with GDM. Furthermore, the LA conduit strain may be a predominant parameter to illustrate subclinical myocardial deterioration in patients with GDM. Conclusions: Two-dimensional speckle tracking echocardiography may sensitively provide quantitative parameters, such as LV-GLS and LA conduit strain, to illuminate subclinical myocardial dysfunction in patients with GDM.