Natural history of left ventricular hypertrophy in infants of diabetic mothers. (1st March 2022)

• Record Type: Journal Article
• Authors: Monda, Emanuele; Verrillo, Federica; Altobelli, Ippolita; Lioncino, Michele; Caiazza, Martina; Rubino, Marta; Cirillo, Annapaola; Fusco, Adelaide; Esposito, Augusto; Di Fraia, Francesco; Pacileo, Roberta; Gragnano, Felice; Passariello, Annalisa; Calabrò, Paolo; Russo, Maria Giovanna; Limongelli, Giuseppe
• Is Part Of: International journal of cardiology. Volume 350(2022)
• Page Start: 77
• Page End: 82
• Publication Date: 2022-03-01
• Subjects: Infants of diabetic mother -- Maternal diabetes -- Left ventricular hypertrophy; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.12.043
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: This study sought to describe the characteristics and the natural course of left ventricular hypertrophy (LVH) in a well-characterized consecutive cohort of infants of diabetic mothers (IDMs). Methods: Sixty consecutive IDMs with LVH have been retrospectively identified and enrolled in the study. All IDMs were evaluated at baseline and every 6 months until LV wall thickness regression, defined as the decrease of wall thickness measurement into the normal reference range for cardiac parameters (z-score > −2 and < 2). A comprehensive assessment was performed in those patients with diagnostic markers suggestive of a different cause and/or without significant reduction of the LVH during follow-up. Results: At 1-year follow-up, all IDMs showed a significant reduction of maximal wall thickness MWT (6.00 mm [IQR 5.00–712] vs. 5.50 mm [IQR 5.00–6.00], p-value <0.001; MWT-z-score: 4.86 [IQR 3.93–7.61] vs. 1.72 [IQR 1.08–2.85], p-value <0.001) compared to baseline, and all patients showed LV wall thickness regression or residual mild or moderate LVH (57%, 28%, and 12%, respectively), except 2 patients with persistent severe LVH, that after a comprehensive clinical-genetic assessment were diagnosed as Noonan syndrome with multiple lentigines. At multivariate analysis, MWT was negatively associated with LV wall thickness regression at 1-year follow-up (MWT-mm: OR 0.48[0.29–0.79], p-value = 0.004; MWT-z-score: OR 0.71[0.56–0.90], p-value = 0.004). Conclusions: LVH in IDMs represents a benign condition with complete regression during the first years of life. In those patients without LV wall thickness regression, combined with clinical markers suggesting a specific disease, a complete work-up is required for a definite diagnosis. Graphical abstract: Unlabelled Image Highlights: 57% of IDMs showed left ventricular wall thickness regression in the first year of age. Two IDMs with persistent severe LVH at 1-year follow-up were diagnosed as NSML. All IDMs showed a LV wall thickness regression in the first 6 years of life.