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Gestational diabetes increases left ventricular mass
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Increased left ventricular mass and impaired left ventricular relaxation and systolic function are independently associated with pregnancies complicated by gestational diabetes, study findings show.
Future risk for cardiovascular disease may be reduced with implementation of postpartum CV health intervention in women with a history of gestational diabetes, according to the researchers.
Duke Appiah, PhD, MPH, of the University of Minnesota, evaluated data from the CARDIA study on 609 women who delivered one or more births during follow-up and had an echocardiogram in 1990-1991 and 2010-2011. Researchers sought to determine the relationship between gestational diabetes with echocardiographic parameters of left ventricular structure and function.
Sixty-four women developed gestational diabetes, and there were 965 live births through 20 years of follow-up.
After adjustment for sociodemographic factors, BMI, physical activity, parity, smoking, use of oral contraceptives, alcohol intake, family history of coronary heart disease, systolic blood pressure and lipid levels, compared with women without gestational diabetes, women with gestational diabetes had impaired longitudinal peak strain (P = .025), circumferential peak strain (P = .028), lateral peak early diastolic mitral annular velocity (e’) wave velocity (P = .012) and septal e’ wave velocity (P = .015) in 2010-2011. A greater 20-year increase in left ventricular mass indexed to body surface area (P = .006) was also found among women with gestational diabetes compared with women without gestational diabetes.
Significantly higher changes in left ventricular mass and left ventricular mass index were found among women with gestational diabetes.
“This study demonstrates impaired [left ventricular] relaxation, lower [left ventricular] systolic function, and a significantly higher progression of [left ventricular mass] among women in whom [gestational diabetes] developed during a 20-year period,” the researchers wrote. “These associations, which are largely independent of incident diabetes, highlight the possibility that [gestational diabetes] identifies a subpopulation of women who are at higher risk of CVD during midlife.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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