Abstract
The aim of this study was to assess the cardiac function in fetuses of mothers with gestational diabetes mellitus (GDM) by using fetalHQ, a quantitative analysis software for the assessment of fetal cardiac function based on speckle tracking echocardiography. In this prospective cross-sectional study, 49 fetuses exposed to GDM and 50 normal fetuses were enrolled and fetal echocardiography were performed and analyzed. In the GDM group, left ventricular (24 ± 4 vs. 28 ± 4, p < 0.001) and right ventricular global longitudinal strain (23 ± 4 vs. 26 ± 4, p = 0.002) and right ventricular free wall strain (26 ± 6 vs. 29 ± 5, p = 0.006) were significantly lower compared with the control group, whereas there was no significant difference in global spherical index (1.2 ± 0.1 vs. 1.2 ± 0.1, p = 0.425). Additionally, 24-segment transverse fraction shortening of the right ventricle was more impaired than the left and the segments with reduced fraction shortening were mainly located in the mid and apical sections of the right ventricle, and mid section of the left ventricle. In conclusion, fetuses exposed to GDM may have cardiac dysfunction before the onset of cardiac morphologic abnormalities, and the right ventricle is more vulnerable than the left during fetal development.
Speckle tracking for the assessment of fetal cardiac function