scholarly journals The etiology of cardiac hypertrophy in infants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Raymond Stegeman ◽  
Nina D. Paauw ◽  
Rosalie de Graaf ◽  
Rosa L. E. van Loon ◽  
Jacqueline U. M. Termote ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiac Hypertrophy ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Maternal Diabetes ◽  
Left Ventricular ◽  
Congenital Hyperinsulinism ◽  
Common Causes ◽  
Malformation Syndromes ◽  
Maternal Diabetes Mellitus

AbstractThis study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. This retrospective cohort study included infants born between 2005 and 2018 with CH measured by echocardiography [interventricular septum (IVS) and/or left ventricular posterior wall (LVPW) thickness with Z-score ≥ 2.0]. Children with congenital heart disease or hypertension were excluded. Underlying diagnosis, echocardiographic and follow-up data were extracted from patient files. Seventy-one infants with CH were included. An underlying cause of CH was identified in two-thirds (n = 47). Most common etiologies of CH were malformation syndromes (n = 23, including Noonan n = 12) and maternal diabetes mellitus (n = 13). Less common causes were congenital hyperinsulinism (n = 3), metabolic- (n = 5), sarcomeric- (n = 2) and neuromuscular disease (n = 1). In half of the identified causes (n = 22) an association with hyperinsulinism was described, including maternal diabetes mellitus (n = 13), malformation syndromes with insulin resistance (n = 6) and congenital hyperinsulinism (n = 3). CH associated with hyperinsulinism was echocardiographically characterized by lower LVPW thickness, higher IVS:LVPW ratio and more frequent sole involvement of the IVS (all, p ≤ 0.02). CH associated with hyperinsulinism normalized more often (41 vs. 0%) with lower mortality rates (14 vs. 44%) compared to CH not associated with hyperinsulinism (all, p ≤ 0.03). Nowadays, an etiology of CH can be identified in the majority of infants. The development of CH is often associated with hyperinsulinism which is mainly characterized by focal hypertrophy of the IVS on echocardiography. Prognosis depends on the underlying cause and is more favorable in CH associated with hyperinsulinism.

scholarly journals The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus

2011 ◽  
Vol 14 (2) ◽  
pp. 49-52
Author(s):  
Irina Arkad'evna Bondar' ◽  
Elena Anatol'evna Koroleva ◽  
Olga Grigor'evna Chudinova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Myocardial Remodeling ◽  
Left Ventricular Myocardial Mass

Aim. To assess the influence of diabetic autonomous neuropathy (DAN) on left ventricular myocardial remodeling in type 1 diabetes mellitus. Materials and methods. The study included 78 patients (30 men and 48 women) with DM1 (mean age 28.9?8.3 years, DM1 duration9.7?7.5 years). DAN was diagnosed by standard ECG tests (Valsalva and breathing tests). The patients were examined using echocardiographywith the measurement of the thickness of interventricular septum (IVS) and left ventricle posterior wall (PW), end diastolic and systolic size (EDS and ESS) of the left ventricle, left ventricular myocardial mass (MM), MM index and relative wall thickness (RWT). LV hypertrophy(LVH) was diagnosed at MM index ?134 g/m2 in men and ?110 g/m2 in women; concentric and excentric types of LV hypertrophy wererecorded at RWT ?0.45 and

scholarly journals Association between Neonatal Intakes and Hyperglycemia, and Left Heart and Aortic Dimensions at 6.5 Years of Age in Children Born Extremely Preterm

2021 ◽  
Vol 10 (12) ◽  
pp. 2554
Author(s):  
Jawwad Hamayun ◽  
Lilly-Ann Mohlkert ◽  
Elisabeth Stoltz Sjöström ◽  
Magnus Domellöf ◽  
Mikael Norman ◽  
...  
Keyword(s):  
Interventricular Septum ◽  
Posterior Wall ◽  
Root Diameter ◽  
Left Ventricular ◽  
Left Heart ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Nutritional Data ◽  
Aortic Dimensions

Survivors of extremely preterm birth (gestational age < 27 weeks) have been reported to exhibit an altered cardiovascular phenotype in childhood. The mechanisms are unknown. We investigated associations between postnatal nutritional intakes and hyperglycemia, and left heart and aortic dimensions in children born extremely preterm. Postnatal nutritional data and echocardiographic dimensions at 6.5 years of age were extracted from a sub-cohort of the Extremely Preterm Infants in Sweden Study (EXPRESS; children born extremely preterm between 2004–2007, n = 171, mean (SD) birth weight = 784 (165) grams). Associations between macronutrient intakes or number of days with hyperglycemia (blood glucose > 8 mmol/L) in the neonatal period (exposure) and left heart and aortic dimensions at follow-up (outcome) were investigated. Neonatal protein intake was not associated with the outcomes, whereas higher lipid intake was significantly associated with larger aortic root diameter (B = 0.040, p = 0.009). Higher neonatal carbohydrate intake was associated with smaller aorta annulus diameter (B = −0.016, p = 0.008). Longer exposure to neonatal hyperglycemia was associated with increased thickness of the left ventricular posterior wall (B = 0.004, p = 0.008) and interventricular septum (B = 0.004, p = 0.010). The findings in this study indicate that postnatal nutrition and hyperglycemia may play a role in some but not all long-lasting developmental adaptations of the cardiovascular system in children born extremely preterm.

scholarly journals 288 Assessing in vivo placental function in pregnancies complicated by maternal diabetes mellitus

2021 ◽  
Vol 224 (2) ◽  
pp. S188-S189
Author(s):  
Stacey Gold ◽  
Catherine Lopez ◽  
Jessica L. Quistorff ◽  
Sarah Downs ◽  
Sara Iqbal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Maternal Diabetes ◽  
Placental Function ◽  
Maternal Diabetes Mellitus

scholarly journals Maternal Diabetes Mellitus as a Risk Factor for High Blood Pressure in Late Childhood

Hypertension ◽  
2019 ◽  
Vol 73 (1) ◽  
Author(s):  
Joana Oliveira Miranda ◽  
Rui João Cerqueira ◽  
Henrique Barros ◽  
José Carlos Areias
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Body Mass ◽  
Cardiovascular Effects ◽  
Maternal Diabetes ◽  
Diabetes Mellitus Group ◽  
The Impact ◽  
Maternal Diabetes Mellitus ◽  
Diabetic Mothers

Intrauterine fetal conditions can have lifelong cardiovascular effects. The impact of maternal diabetes mellitus on children’s cardiovascular profile is not well established. The goal of this study was to explore the association between maternal diabetes mellitus and offspring’s blood pressure (BP) ≤10 years of age. Generation XXI is a prospective birth cohort, which enrolled 8301 mother-offspring pairs, including 586 (7.1%) children of diabetic mothers. The associations between maternal diabetes mellitus and BP at 4, 7, and 10 years of age was modeled using linear regression. A mixed-effects model was built to assess differences in BP variation over time. Path analysis was used to quantify effects of potential mediators. Maternal diabetes mellitus was associated with higher BP in offspring at the age of 10 (systolic: β, 1.48; 95% CI, 0.36–2.59; and diastolic: β, 0.86; 95% CI, 0.05–1.71). This association was independent of maternal perinatal characteristics, and it was mediated by child’s body mass index and, to a lesser extent, by gestational age, type of birth, and birth weight (indirect effect proportion, 73%). No significant differences in BP were found at 4 and 7 years of age. Longitudinal analysis showed an accelerated systolic BP increase on maternal diabetes mellitus group (β, 1.16; 95% CI, 0.03–2.28). These finding were especially relevant in males, suggesting sex differences in the mechanisms of BP prenatal programing. Our results provide further evidence that maternal diabetes mellitus is associated with high BP late in childhood, demonstrating a significant role of child’s body mass in the pathway of this association.

scholarly journals Left ventricular geometric patterns and cardiac function in patients with chronic renal failure undergoing hemodialysis

2005 ◽  
Vol 64 (1) ◽  
Author(s):  
Maria Teresa Manes ◽  
Manlio Gagliardi ◽  
Gianfranco Misuraca ◽  
Stefania Rossi ◽  
Mario Chiatto
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diastolic Dysfunction ◽  
Cardiac Troponin ◽  
Ventricular Hypertrophy ◽  
Interventricular Septum ◽  
Myocardial Damage ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Posterior Wall Thickness ◽  
Significant Difference

The aim of this study was to estimate the impact and prevalence of left ventricular geometric alterations and systolic and diastolic dysfunction in hemodialysis patients, as well as the relationship with cardiac troponin as a marker of myocardial damage. Methods: 31 patients (pts), 19 males and 12 females, age 58.1±16.4 (26 on hemodialysis, 5 on peritoneal dialysis) and 31 healthy normal controls were enrolled. Echocardiography measurements were carried out according to the American Society of Echocardiography recommendations. Left ventricular mass was calculated, according to the Devereux formula and indexed to height and weight 2.7. Doppler echocardiography was performed to study diastolic function by measurements of isovolumetric relaxation period (IVRT), E wave deceleretion time (DTE) and E/A ratio. Cardiac troponin was measured by a third generation electrochemiluminescence immunoassay. Statistical analysis was performed using the t-test for between-group comparisons and the Pearson and Spearman’s tests to investigate correlations; p values of &lt;0.05 were considered statistically significant. Results: Eccentric hypertrophy was the most frequent pattern (n=17; 55%), followed by normal cardiac geometry (n=7; 23%), and concentric hypertrophy (n=5; 16%). Only 6% of pts (n=2) showed concentric remodelling. Systolic dysfunction was present in terms of endocardial parameters in 3 pts (9%) (fractional shartening &lt;25%, EF&lt;50%), but in terms of midwall myocardial shortening in 51% (n=16). Diastolic dysfunction was present in 87% (n=27) with a pattern of impaired relaxation (in 5 without left ventricular hypertrophy). E/A was negatively correlated with age (r=-0.41, p=0.02); DTE was positively correlated with posterior wall thickness (r=0.36, p=0.05) and interventricular septum thickness (r=0.45, p=0.01); cardiac troponin was positively correlated with age (r=0.50, p=0.00), left ventricular mass (r=0.41, p=0.02), posterior wall thickness (r=0.41; p=0.02) and interventricular septum thickness (r=0.39, p=0.03) but not with diastolic dysfunction parameters. No significant difference was found in terms of duration of dialysis between patients with normal left ventricular geometry and those with left ventricular hypertrophy, but a significant difference in age was found (p=0.03). Pts with diastolic dysfunction had more frequent hypotensive episodes during dialysis (p &lt;0.01). Conclusion: Impaired geometry and cardiac function is frequently observed in pts undergoing hemodialysis. Diastolic dysfuction is associated to a geometric pattern of left ventricular hypetrophy, although it can be an isolated initial manifestation of myocardial damage. Depressed midwall myocardial shortening can discriminate left ventricular dysfunction better than traditional endocardial systolic indexes.

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