title: Gestational diabetes: a condition of early diastolic abnormalities in young women.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) is not merely a temporary condition, but a harbinger of type 2 diabetes mellitus, hypertension, and atherosclerotic disease. We examined the effect of GDM on cardiac diastolic function.
  
  
  METHODS
  Diastolic function was evaluated by serial Doppler echocardiography with pulsed tissue Doppler imaging in 13 patients with GDM and 13 healthy pregnant women (control group) during the third trimester of pregnancy and after 8 weeks postpartum. Diagnostic criteria for GDM were those as recommended by the American Diabetes Association. Exclusion criteria were any disease or condition that could interfere with diastolic function. Measurements at both times in each group were compared by paired t tests and changes of patients with diabetes were compared with those in control patients by unpaired t tests.
  
  
  RESULTS
  There were no differences in age, left ventricular mass, or systolic function between groups. The Doppler parameters that showed significant difference between groups were higher atrial contraction wave (A wave) (P = .008) and lower rapid filling wave (E)/A ratio (P = .006) in diabetic group, on both occasions. Tissue Doppler parameters showed a significant decrease in Em (P = .002) and early mitral annulus velocity (Em)/late mitral annulus velocity (Am) (P = .008) in diabetic group on both occasions, and the Am wave remained increased only in the diabetic group at postpartum.
  
  
  CONCLUSIONS
  Patients with GDM showed a different diastolic function profile, suggesting a mild degree of diastolic abnormality. The persistence of some abnormalities postpartum corroborates our hypothesis of an early cardiovascular involvement in this group, enhancing the need of a close cardiovascular follow-up of these patients.
authors.affiliation: Federal University of Minas Gerais, School of Medicine, Laboratory of Endocrine Research, Belo Horizonte, Brazil.
authors.forename: Claudia Maria Vilas
authors.initials: CM
authors.lastname: Freire
authors.forename: Maria do Carmo Pereira
authors.initials: Mdo C
authors.lastname: Nunes
authors.forename: Marcia Melo
authors.initials: MM
authors.lastname: Barbosa
authors.forename: Junia Ribeiro de Oliveira
authors.initials: JR
authors.lastname: Longo
authors.forename: Anelise Impeliziere
authors.initials: AI
authors.lastname: Nogueira
authors.forename: Sivana Santos Assreuy
authors.initials: SS
authors.lastname: Diniz
authors.forename: Lucas José Campos
authors.initials: LJ
authors.lastname: Machado
authors.forename: Antonio Ribeiro
authors.initials: AR
authors.lastname: de Oliveira
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000000981:diagnostic imaging*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*