Ductus venosus flow and myocardial hypertrophy in fetuses of diabetic mothers.
OBJECTIVE
To test the hypothesis that the pulsatility index of ductus venosus (PIDV) is greater in the fetuses of diabetic mothers (FDM) with myocardial hypertrophy (MH) than in the FDM with no MH and in the control fetuses of nondiabetic mothers (FNDM). Comparing the results with mitral and tricuspid diastolic peak flows.


METHODS
The cross-sectional study included fetuses with gestational ages ranging from 20 weeks to term, divided into the following 3 groups: 56 FDM with MH (group I), 36 FDM with no MH (group II), and 53 FNDM (group III, control). The Doppler echocardiogram assessed the PIDV through the ratio (systolic velocity - presystolic velocity)/mean velocity. The mitral and tricuspid E and A waves were also assessed.


RESULTS
The mean PIDV in groups I, II, and III were 1.13 +/- 0.64, 0.84 +/- 0.38, and 0.61 +/- 0.17, respectively. Using ANOVA and the Tukey test, a statistically significant difference was found in the 3 groups (P = 0.015 between groups I and II; P < 0.001 between groups I and III; and P = 0.017 between groups II and III). The mean mitral E wave was significantly greater in group I (0.39 +/- 0.12 m/s) than in groups II (0.32 +/- 0.08 m/s) (P = 0.024) and III (0.32 +/- 0.08 m/s) (P = 0.023). The mean tricuspid E wave was also greater in group I (0.43 +/- 0.1 m/s) than in group III (0.35 +/- 0.10 m/s) (P = 0.031).


CONCLUSIONS
The PIDV is significantly greater in FDM with MH than in FDM with no MH and in FNDM. Because the PIDV may represent modifications in ventricular compliance, this index may be a more sensitive parameter for assessing fetal diastolic function.
Fetal Cardiology Unit, Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. zielinsky@cardiol.br
Paulo
P
Zielinsky
Silvana
S
Marcantonio
Luiz Henrique
LH
Nicoloso
Stelamaris
S
Luchese
Domingos
D
Hatem
Marlui
M
Scheid
João Luiz
JL
Mânica
Eduardo Ioschpe
EI
Gus
Fabíola
F
Satler
Antônio L
AL
Piccoli
D001783:Blood Flow Velocity; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000196:embryology*; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D008943:Mitral Valve / Q000503:physiopathology; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D011673:Pulsatile Flow; D014261:Tricuspid Valve / Q000503:physiopathology