| Objective:The objective of this study was to employ routine echocardiography and two-dimensional speckle tracking imaging technology to evaluate the left ventricular cardiac function in patients with gestational diabetes mellitus(GDM)before and after pregnancy and to explore the independent influencing factors.Methods:Forty-two clinically confirmed GDM patients were chosen as the object of study,and choose twenty nine healthy pregnant women to be the matched group.Both groups underwent fasting blood glucose test and oral OGTT test in the second trimester,and HbAlc was monitored several times during pregnancy.Routine echocardiography and two-dimensional speckle tracking imaging technology were performed in the third trimester and about 3 months postpartum,and image post-processing was performed.Independent sample t test was used between groups.Pearson test was used for correlation analysis between the two variables,stepwise multiple linear regression analysis was used to analyze the independent influencing factors of left ventricular systolic function,and scatter plots and regression equations were made.All results were statistically significant at P<0.05.Results:1.The general clinical data contrast:GDM compared to control group,fasting blood-glucose,1h OGTT,2h OGTT,glycosylated hemoglobin have a statistically significant difference(P<0.01),the pulse pressure was statistically difference(P<0.05),height,weight,BMI,BSA,systolic pressure,diastolic blood pressure,triglyceride,total cholesterol,high-density lipoprotein cholesterol,low density lipoprotein cholesterol had no statistical difference(P>0.05).2.Comparison of conventional echocardiographic parameters:compared with the control group,GDM group had thicker left ventricular posterior wall thickness,lower mitral ring velocity at early diastolic stage,and higher Tei index,the differences were statistically significant(P<0.01).3.In the third trimester,compared with the control group,the GPLS、stratified GLS,GCS and GCS-mid of GDM pregnant women decreased to different degrees,with statistical significance(P<0.05).There was no significant difference in GRS and torsion parameters(P>0.05).4.At about 3 months postpartum,compared with the control group,the GPLS and stratified GLS in pregnant women with GDM decreased to varying degrees,with statistical significance(P<0.05).There was no significant difference in GCS,GRS and torsion parameters(P>0.05).5.In both the GDM group and the observation group,compared with the third trimester,the GPLS,stratified GLS and torsion parameters were improved at 3 months postpartum,with statistical significance(P<0.05).6.The GPLS and GCS of left ventricular myocardium in GDM group and control group decreased layer by layer from subendocardial myocardium、medial myocardium to subepicardial myocardium.The GLS increased from mitral valve level,papillary muscle level to apex level.7.Correlation analysis and linear regression analysis showed that there was a certain correlation between GPLS and Tei.HbA1c and postprandial blood glucose can affect left ventricular myocardial systolic function in pregnant women with GDM to a certain extent,and active and strict control of blood glucose is the key to prevent early cardiovascular risk in pregnant women with GDM.Conclusion:The results of this study indicated that the left heart function of pregnant women with GDM in the third trimester were significantly impaired,but the cardiac function recovered to a certain extent about 3 months after delivery.Multiple linear regression analysis suggested that left ventricular systolic function was affected by HbAlc and postprandial blood glucose to some extent.This study also shows that GPLS can detect the damage of systolic function in pregnant women with GDM in the subclinical early stage,and two-dimentional speckle-tracking echocardiography is a more accurate and sensitive technique to evaluate the early damage of cardiac function in pregnant women with GDM. |
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