Cardiac function in fetuses of type I diabetic mothers

Abstract

Cardiac function was cross-sectionally studied by means of M-mode and Doppler echocardiography in 40 fetuses of mothers with well-controlled insulin-dependent diabetes at 20 to 38 weeks of gestation. These variables were measured: interventricular septal thickness, ratio between the peak velocities during early passive ventricular filling and active atrial filling at the level of the atrioventricular valves, peak velocities, and the time to peak velocity at the level of the ascending aorta and the pulmonary artery. The values obtained were compared with our reference limits for gestation. A significant increase of interventricular septal thickness that was unrelated to maternal glycosylated hemoglobin levels was evidenced. Early passive ventricular filling/active atrial filling ratios were significantly lower in fetuses of diabetic mothers than in control fetuses. These differences were significantly related to interventricular septal thickness. No significant modifications were found in either aortic or pulmonary peak velocities or in time to peak velocity values. These findings suggest that in spite of an adequate metabolic control an interventricular septal hypertrophy that affects cardiac diastolic function develops in fetuses of diabetic mothers.