Fetal Strain and Strain Rate Measured with Speckle Tracking Echocardiography in Maternal Diabetes: Systematic Review.

IF 1.6 3区 医学 Q3 OBSTETRICS & GYNECOLOGY Fetal Diagnosis and Therapy Pub Date : 2024-07-17 DOI:10.1159/000538413
Chantelle de Vet, Hossy Zamani, Daisy van der Woude, Sally-Ann Clur, Guid Oei, Judith van Laar, Noortje van Oostrum
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Abstract

Introduction: The aim of this systematic review and meta-analysis was to evaluate fetal cardiac function in fetuses of mothers with diabetes compared to those of mothers without diabetes using 2D-STE.

Methods: Embase, MEDLINE, and CENTRAL were searched for observational studies on 2D-STE fetal left and right ventricular global longitudinal strain and strain rate that included singleton, non-anomalous pregnancies complicated by pregestational or gestational diabetes mellitus compared to uncomplicated pregnancies. The strain values were pooled per 4 weeks of gestation for meta-analysis using random-effects models.

Results: Fifteen studies met the criteria, including 990 fetuses of diabetic mothers and 1,645 control fetuses. The study design was cross-sectional in fourteen studies and longitudinal in one study. Gestational age, type of diabetes, ultrasound device, and 2D-STE software varied between the studies. Glycemic control and type of treatment were often lacking. In fetuses of diabetic mothers versus healthy mothers, left ventricular strain was significantly decreased (7 studies), increased (1 study), or not significantly different (7 studies). Right ventricular strain was decreased (7 studies), increased (1 study), or not different (2 studies). Left ventricular strain rate was decreased (3 studies), increased (1 study), or not different (2 studies). Right ventricular strain rate was increased (1 study) or not different (2 studies).

Conclusion: Fetuses of mothers with diabetes show evidence of systolic dysfunction, which is more visible in the right ventricle. Contradictory results are probably due to suboptimal study designs and variation in gestational age, diabetes severity, image acquisition, and software. Large prospective longitudinal studies are needed to assess fetal myocardial function with 2D-STE in pregestational diabetes mellitus type 1 and 2 and gestational diabetes mellitus pregnancies. The influence of glycemic control, BMI, and treatment should be evaluated.

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用斑点追踪超声心动图测量母体糖尿病患者的胎儿应变和应变率:系统综述。
简介:这项系统性综述和荟萃分析的目的是利用 2D-STE 评估糖尿病母亲与非糖尿病母亲胎儿的胎儿心脏功能:方法: 通过Embase、MEDLINE和CENTRAL检索了有关二维STE胎儿左心室和右心室整体纵向应变和应变率的观察性研究,这些研究包括单胎、因妊娠前或妊娠期糖尿病而并发的非异常妊娠与非并发妊娠的比较。使用随机效应模型对每4周妊娠的应变值进行汇总,以进行荟萃分析:15项研究符合标准,包括990名糖尿病母亲的胎儿和1645名对照组胎儿。14 项研究的研究设计为横断面研究,1 项研究为纵断面研究。不同研究的妊娠年龄、糖尿病类型、超声设备和 2D-STE 软件各不相同。血糖控制和治疗类型往往缺失。与健康母亲相比,糖尿病母亲的胎儿左心室应变显著降低(7 项研究)、增加(1 项研究)或无显著差异(7 项研究)。右心室应变减少(7 项研究)、增加(1 项研究)或无差异(2 项研究)。左心室应变率降低(3 项研究)、升高(1 项研究)或无差异(2 项研究)。右心室应变率增加(1 项研究)或无差异(2 项研究):结论:母亲患有糖尿病的胎儿会出现收缩功能障碍,这在右心室更为明显。结论:患有糖尿病的母亲所怀的胎儿有收缩功能障碍的迹象,右心室更为明显。出现矛盾的结果可能是由于研究设计不够理想,以及妊娠年龄、糖尿病严重程度、图像采集和软件的不同造成的。需要进行大型前瞻性纵向研究,用二维STE评估妊娠前1型和2型糖尿病妊娠及妊娠期糖尿病妊娠的胎儿心肌功能。应评估血糖控制、体重指数和治疗的影响。
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来源期刊
Fetal Diagnosis and Therapy
Fetal Diagnosis and Therapy 医学-妇产科学
CiteScore
4.70
自引率
9.10%
发文量
48
审稿时长
6-12 weeks
期刊介绍: The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.
期刊最新文献
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