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Depressed left and right ventricular cardiac output in fetuses of diabetic mothers

Echo Research & Practice volume 5, pages 19–26 (2018)Cite this article

Abstract

Introduction We compared right and left ventricular cardiac output (RVCO and LVCO) in fetuses of diabetic mothers (FDM) with a large normal cohort.

Methods: We prospectively enrolled 264 normal fetuses and 30 FDM. Fetal CO parameters such as semilunar valve velocity time integrals (AVVTI, PVVTI), ventricular outflow diameters (LVOTD, RVOTD) and stroke volumes (AVSV, PVSV) were measured, and LVCO and RVCO were calculated. These were normalized using non-linear regression to estimated fetal weight (EFW) to provide means and standard deviations. Among FDMs, mean Z scores and 95% confidence limits (CL) were calculated and compared to zero.

Results: LVCO, RVCO and parameters they were calculated from, increased predictably and non-linearly with increasing EFW. In FDM, LVCO was depressed (mean Z −1.679, 95% CL −2.404, −0.955, P < 0.001), and AVVTI, LVOTD and AVSV were significantly lower than normal. Similarly, RVCO (mean Z = −1.119, CL −1.839, −0.400, P = 0.003), RVOTD (mean −2.085, CL −3.077, −1.093, P < 0.001) and PVSV (mean −1.184, CL −1.921, −0.446, P = 0.003) were lower than normal, however, PVVTI was not different (mean Z 0.078, CL −0.552, +0.707, P = 0.803).

Conclusion: Normal biventricular stroke volumes and outputs follow a non-linear regression with EFW. FDM have significantly lower right and left heart stroke volumes and outputs for weight than do normal fetuses.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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  1. (J Winter and A Kulkarni contributed equally to this work)

Authors and Affiliations

  1. University of Nebraska Medical Center and Children’s Hospital and Medical Center, Omaha, Nebraska, USA

    Jennifer Winter MD, Mary Craft RDCS, Ling Li MD PhD, Lisa K. Hornberger MD & Shelby Kutty MD PhD MS-HCM

  2. Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, New York, USA

    Aparna Kulkarni MD

  3. Stollery Children’s Hospital, Edmonton, Alberta, Canada

    David A. Danford MD

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  1. Jennifer Winter MD
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  2. Aparna Kulkarni MD
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  3. Mary Craft RDCS
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  7. Shelby Kutty MD PhD MS-HCM
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Winter, J., Kulkarni, A., Craft, M. et al. Depressed left and right ventricular cardiac output in fetuses of diabetic mothers. Echo Res Pract 5, 19–26 (2018). https://doi.org/10.1530/ERP-17-0063

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