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

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), v...

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Autores principales: Winter, Jennifer, Kulkarni, Aparna, Craft, Mary, Li, Ling, Hornberger, Lisa K, Danford, David A, Kutty, Shelby
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776151/
https://www.ncbi.nlm.nih.gov/pubmed/29335254
http://dx.doi.org/10.1530/ERP-17-0063
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author Winter, Jennifer
Kulkarni, Aparna
Craft, Mary
Li, Ling
Hornberger, Lisa K
Danford, David A
Kutty, Shelby
author_facet Winter, Jennifer
Kulkarni, Aparna
Craft, Mary
Li, Ling
Hornberger, Lisa K
Danford, David A
Kutty, Shelby
author_sort Winter, Jennifer
collection PubMed
description 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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spelling pubmed-57761512018-01-24 Depressed left and right ventricular cardiac output in fetuses of diabetic mothers Winter, Jennifer Kulkarni, Aparna Craft, Mary Li, Ling Hornberger, Lisa K Danford, David A Kutty, Shelby Echo Res Pract Research 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. Bioscientifica Ltd 2017-12-12 /pmc/articles/PMC5776151/ /pubmed/29335254 http://dx.doi.org/10.1530/ERP-17-0063 Text en © 2018 The authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Research
Winter, Jennifer
Kulkarni, Aparna
Craft, Mary
Li, Ling
Hornberger, Lisa K
Danford, David A
Kutty, Shelby
Depressed left and right ventricular cardiac output in fetuses of diabetic mothers
title Depressed left and right ventricular cardiac output in fetuses of diabetic mothers
title_full Depressed left and right ventricular cardiac output in fetuses of diabetic mothers
title_fullStr Depressed left and right ventricular cardiac output in fetuses of diabetic mothers
title_full_unstemmed Depressed left and right ventricular cardiac output in fetuses of diabetic mothers
title_short Depressed left and right ventricular cardiac output in fetuses of diabetic mothers
title_sort depressed left and right ventricular cardiac output in fetuses of diabetic mothers
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776151/
https://www.ncbi.nlm.nih.gov/pubmed/29335254
http://dx.doi.org/10.1530/ERP-17-0063
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