Application of left ventricular myocardial function in pregnant women with impaired glucose tolerance in the third trimester and the predictive value on perinatal adverse events
10.3760/cma.j.cn131148-20220228-00135
- VernacularTitle:孕晚期糖耐量受损初产妇左室心肌做功改变及其对围生期不良事件预测价值初探
- Author:
Limin ZHU
1
;
Ting YE
;
Jianjun YUAN
;
Tingting LIU
;
Bingbing LIU
;
Haohui ZHU
Author Information
1. 河南省人民医院 郑州大学人民医院超声科，郑州 450003
- Keywords:
Pressure-strain loop;
Impaired glucose tolerance;
Gestational diabetes mellitus;
Myocardial work;
Ventricular function, left
- From:
Chinese Journal of Ultrasonography
2022;31(10):845-851
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate left ventricular myocardial work in pregnant women with impaired glucose tolerance(IGT) in the third trimester by the non-invasive technical parameters of pressure-strain loop(PSL), and to explore its predictive value of risk of perinatal adverse events.Methods:From October 2020 to October 2021, 70 pregnant women of IGT and 50 healthy pregnant women in Henan Provincial People′s Hospital were included, and a 75 g oral glucose tolerance test(OGTT) was performed at 24-28 weeks. Then their routine obstetric examinations were followed up until one week postpartum and perinatal adverse events were recorded, such as diabetic mother-infant syndrome, macrosomia, et al. After 36 weeks of pregnancy before childbirth, echocardiography was performed and dynamic images of 3-5 cardiac cycles at apical four-chamber view, three-chamber view, and two-chamber view were recorded.Simultaneously, pressure-strain loop(PSL) curve, left ventricular global longitudinal strain(GLS), global work index(GWI), global constructive work(GCW), global wasted work(GWW) and global work efficiency(GWE) were calculated through the EchoPAC 203 workstation. Then the differences of all parameters were compared between the two groups. And a prediction model for perinatal adverse events was built by binary logistic regression, and ROC curve was used to analyze the prediction efficiencies of the prediction model and each independent influencing factor.Results:Compared with the control group, the absolute values of GLS, GWI and GCW of IGT group were lower(all P<0.05). The incidence of perinatal adverse events of the IGT group, including adverse pregnancy outcomes and neonatal adverse outcomes, was higher than that in the control group( P<0.05). According to logistic regression model, the GLS, GWI, GCW and 2-hour postprandial blood glucose(2-hPBG) were independent influencing factors for perinatal complications(all P<0.05); in addition, ROC curve anaysis showed the area under the curve of the predictive model based on the influencing factors, GLS, GWI, GWE and 2-h PBG were respectively 0.903, 0.820, 0.879, 0.854 and 0.771. Conclusions:The parameters of PSL can quantitatively assess the changes of left ventricular myocardial work in pregnancy women with IGT; and the incidence of perinatal adverse events in IGT pregnant women is higher; GWI, GCW, the models constructed based on GLS, GWI, GCW and 2-hPBG have potential values in predicting the risk of perinatal adverse events.
