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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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Association of Gestational Diabetes Mellitus With Left Ventricular Structure and Function: The CARDIA Study

Duke Appiah1, Pamela J Schreiner2, Erica P Gunderson3

  • 1University of Minnesota, Minneapolis, MN dappiah@umn.edu.

Diabetes Care
|January 8, 2016
PubMed

Insights

Gestational diabetes mellitus (GDM) is linked to lasting heart changes, including increased left ventricular (LV) mass and impaired function, independent of type 2 diabetes. Early cardiovascular health interventions for women with GDM history are recommended.

Area of Science:

  • Cardiology
  • Obstetrics
  • Endocrinology

Background:

  • Gestational diabetes mellitus (GDM) is a known risk factor for future cardiovascular disease (CVD).
  • The specific mechanisms linking GDM to CVD, beyond the development of type 2 diabetes, remain unclear.
  • Left ventricular (LV) structure and function are critical indicators of cardiovascular risk.

Purpose of the Study:

  • To investigate the association between GDM and echocardiographic measures of LV structure and function.
  • To determine if GDM independently predicts adverse cardiac remodeling and dysfunction over a 20-year period.

Main Methods:

  • A longitudinal study of 609 women from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
  • Echocardiograms were performed at baseline and after a 20-year follow-up.
  • Statistical models adjusted for multiple cardiovascular risk factors and incident type 2 diabetes.

Main Results:

  • Women with GDM exhibited impaired longitudinal and circumferential peak strain, reduced e' wave velocities, and a greater increase in LV mass over 20 years compared to women without GDM.
  • These associations remained significant even after adjusting for sociodemographic factors, lifestyle, and incident type 2 diabetes.
  • The findings highlight persistent cardiac alterations following GDM pregnancies.

Conclusions:

  • Pregnancy with GDM is independently associated with adverse changes in LV mass, relaxation, and systolic function.
  • These cardiac changes suggest an elevated risk for future cardiovascular events.
  • Postpartum cardiovascular health interventions in women with a history of GDM may be crucial for mitigating long-term CVD risk.
Abstract

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