The Feasibility Study Of Ultrasonic Evaluation Of Left Ventricular Function In Pregnant Women With Diabetes In Mid And Late Pregnancy

Objective : To evaluate the left ventricular function of pregnant women with gestational diabetes in mid and late pregnancy by echocardiography,and to explore the effect of long-term hyperglycemia on the heart of pregnant women.Methods : Forty pregnant women diagnosed as gestational diabetes in our hospital were selected.Echocardiography was used to evaluate the parameters of left atrium and left ventricle in the second and third trimester of pregnancy respectively.At the same time,30 pregnant women with normal pregnancy were selected for echocardiography in the second and third trimesters of pregnancy.The left atrial diameter(LAD),left ventricular diastolic diameter(LVEDD),left ventricular systolic diameter(LVESD),ventricular septum(IVSD),and left ventricular posterior wall thickness(LVPWD)were recorded by two-dimensional ultrasound,the left ventricular ejection fraction(LVEF)was recorded by M-mode ultrasound,and the peak flow velocity(E)at the early diastolic stage of mitral valve orifice and the peak flow velocity(A)at the late diastolic stage of mitral valve orifice were recorded by spectral Doppler The ratio of early diastolic peak velocity to late diastolic peak velocity(E/A),the average peak velocity of left ventricular sidewall and septal mitral annulus(e ’),and the ratio of early diastolic peak velocity to mitral annulus(E/e’).The strain of left atrium and left ventricle was measured by spot tracking technique,including left atrial storage strain(LASr),left atrial duct strain(LAScd),left atrial systolic strain(LASct),endocardial longitudinal systolic peak strain(LS endo),median longitudinal systolic peak strain(LS mid),epicardial longitudinal systolic peak strain(LS epi)and endocardial circumferential systolic peak strain(CS endo)The peak circumferential systolic strain(CS mid)of the middle myocardium and the peak circumferential systolic strain(CS epi)of the epicardial myocardium.The test method was selected according to the data type,and the correlation analysis was carried out.The difference was considered statistically significant by P<0.05.Results:1.Comparison of two-dimensional ultrasound parameters: Compared with GDM during pregnancy and the control group during late pregnancy,the IVSD and LVPWD of GDM during late pregnancy were relatively thickened,and the difference was statistically significant.2.Comparison of spectral Doppler and tissue Doppler parameters: In the GDM group,e’significantly decreased and E/e’ significantly increased in late pregnancy compared to mid pregnancy,with statistical differences;During mid pregnancy,the GDM group showed a significant decrease in e ’compared to the control group;In late pregnancy,compared with the control group,the GDM group showed a significant decrease in e ’and a significant increase in E/e’.3.Comparison of two-dimensional speckle tracking ultrasound parameters: during the middle pregnancy,GLS-endo,GLS-mid and GLS-epi in GDM group were significantly lower than those in the control group;In late pregnancy,compared with the control group,LASr,LAScd,GLS-endo,GLS-mid and GLS-epi in GDM group were significantly decreased in late pregnancy,with statistical difference;In GDM group,LASr,LAScd,GLS-endo,GLS-mid,GLS-epi,GCS-endo were significantly lower in late pregnancy than in middle pregnancy,and LASct was significantly higher,with statistical difference.Conclusion:Through the analysis of the left heart ultrasonic parameters of pregnant women with gestational diabetes in mid and late pregnancy,it was found that the left heart function of pregnant women changed,indicating that long-term hyperglycemia affected the left atrial and left ventricular function of pregnant women,and the damage gradually aggravated with the increase of gestational weeks.Two-dimensional spot tracking technology can accurately and quantitatively evaluate early and subtle myocardial changes.