Persistent Aortic Stiffness and Left Ventricular Hypertrophy in Children of Diabetic Mothers

Victor Do, Luke Eckersley, Lily Lin, Sandra T. Davidge, Michael K. Stickland, Tiina Ojala, Jesus Serrano-Lomelin, Lisa K. Hornberger

Tutkimustuotos: ArtikkelijulkaisuArtikkeliTieteellinenvertaisarvioitu


Background: Fetuses of diabetic mothers develop left ventricular (LV) hypertrophy and are at increased long-term risk of cardiovascular disease. In our previous longitudinal study from midgestation to late infancy we showed persistence of LV hypertrophy and increased aortic stiffness compared with infants of healthy mothers, the latter of which correlated with third trimester maternal hemoglobin A1c. In the present study, we reexamined the same cohort in early childhood to determine if these cardiovascular abnormalities persisted. Methods: Height, weight, and right arm blood pressure were recorded. A full functional and structural echocardiogram was performed with offline analysis of LV posterior wall and interventricular septal diastolic thickness (IVSd), systolic and diastolic function, and aortic pulse wave velocity. Vascular reactivity was assessed using digital thermal monitoring. Participants also completed a physical activity questionnaire. Results: Twenty-five children of diabetic mothers (CDMs) and 20 children from healthy pregnancies (mean age, 5.6 ± 1.7 and 5.3 ± 1.3 years, respectively; P = not significant) were assessed. Compared with controls, IVSd z score was increased in CDMs (1.2 ± 0.6 vs 0.5 ± 0.3, respectively; P = 0.006), with one-fifth having a z score of more than +2.0. Aortic pulse wave velocity was increased in CDMs (3.2 ± 0.6 m/s vs 2.2 ± 0.4 m/s; P = 0.001), and correlated with IVSd z score (R2 = 0.81; P = 0.001) and third trimester maternal A1c (R2 = 0.65; P < 0.0001). Body surface area, height, weight, blood pressure, vascular reactivity, and physical activity scores did not differ between groups. Our longitudinal analysis showed that individuals with greater IVSd, and aortic stiffness in utero, early and late infancy also tended to have greater measures in early childhood (P < 0.001 and P < 0.0001, respectively). Conclusions: CDMs show persistently increased interventricular septal thickness and aortic stiffness in early childhood.

LehtiCJC Open
DOI - pysyväislinkit
TilaJulkaistu - maalisk. 2021
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä, vertaisarvioitu


Funding Information:
This study was funded by the University of Alberta’s Women’s and Children’s Health Research Institute through donations from the Royal Alexandra Hospital Foundation, the Stollery Children’s Hospital Foundation and supporters of the Lois Hole Hospital for Women. Victor Do was supported by a Summer Student Grant through Alberta Innovates Health Solutions and a Women and Children's Health Research Institute Summer Studentship.

Publisher Copyright:
© 2020 Canadian Cardiovascular Society


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