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Background: Cardiovascular abnormalities in infants of diabetic mothers (IDMs) occur in the form of congenital heart diseases (CHD) and cardiomyopathy.
Aim of the Work: We hypothesized that two dimensional speckle tracking imaging (STI) and pulsed wave tissue Doppler imaging (TDI) may uncover subtle decrease in myocardial function in IDM compared to infants of non –diabetics.
Patients and Methods: This study was a Prospective descriptive study conducted at Ain shams University Children’s Hospital Pediatric cardiology unit during the period from June 2017 till June 2017. Thirty neonates born to diabetic mothers were recruited. They were further subdivided into 2 groups; Infants of gestational diabetic mothers (IGDM) and infants of pregestational diabetic mothers (IPGDM). They were all examined at less than 7 days of life. This group was compared to a group of age and sex matched controls.
Patients underwent conventional echocardiography, tissue Doppler Imaging (TDI) and two dimensional speckle tracking imaging (STI).
Results: All IDMs had normal cardiac dimensions and global cardiac functions as controls, IVS (P=0.434), LVED (P=0.318), EF (P=0.291), LVFS(P=0.644) and GLS(P=0.240) .However , Infants of diabetics had an evidence of LV dysfunction proved by prolonged Tei index(MPI) (p=0.018). This subtle affection of myocardial function was more prominent in infants of pre-gestational diabetic mothers when compared to infants of gestational DM mothers(P=0.004).
Conclusion: In infants of diabetic mothers without morphological cardiac changes by conventional echocardiography, subtle affection of myocardial functions may occur which can be detected by TDI derived myocardial performance index (MPI) .Neither conventional assessment of myocardial functions, nor STI are sensitive tools in detecting these changes. Infants of pre-gestational DM mothers are at risk of more profound affection of myocardial function than infants of gestational DM mothers.