A novel association of biventricular cardiac noncompaction and diabetic embryopathy: case report and review of the literature.
Diabetic embryopathy refers to a constellation of congenital malformations arising in the setting of poorly controlled maternal diabetes mellitus. Cardiac abnormalities are the most frequently observed findings, with a 5-fold risk over normal pregnancies. Although a diverse spectrum of cardiac defects has been documented, cardiac noncompaction morphology has not been associated with this syndrome. In this report, we describe a novel case of biventricular cardiac noncompaction in a neonate of a diabetic mother. The patient was a late preterm female with right anotia, caudal dysgenesis, multiple cardiac septal and aortic arch defects, and biventricular cardiac noncompaction. Examination of both ventricles demonstrated spongy myocardium with increased myocardial trabeculation greater than 50% left ventricular thickness and greater than 75% right ventricular thickness, with hypoplasia of the bilateral papillary muscles, consistent with noncompaction morphology. Review of the literature highlights the importance of gene expression and epigenomic regulation in cardiac embryogenesis.
1 Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS 13-145, Los Angeles, CA, USA.
Jennifer S
JS
Woo
Mari
M
Perez-Rosendahl
Dana
D
Haydel
Gregory
G
Perens
Michael C
MC
Fishbein
D000015:Abnormalities, Multiple / Q000175:diagnosis*; D048909:Diabetes Complications; D004452:Echocardiography / Q000379:methods; D017809:Fatal Outcome; D005260:Female; D005315:Fetal Diseases / Q000473:pathology; D006321:Heart / Q000196:embryology; D006330:Heart Defects, Congenital; D006331:Heart Diseases / Q000151:congenital / Q000175:diagnosis*; D006352:Heart Ventricles / Q000196:embryology / Q000473:pathology; D006801:Humans; D009206:Myocardium / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications; D011254:Pregnancy in Diabetics
cardiac noncompaction; congenital heart disease; diabetic embryopathy; embryogenesis