Comprehensive Assessment of Biventricular and Biatrial Myocardial Strain Parameters at 4 Years Postpartum in a Cohort of Women with Previous Gestational Diabetes Mellitus

Background: To date, myocardial strain parameters have been poorly investigated in women with previous gestational diabetes mellitus (pGDM). No previous study provided a comprehensive evaluation of all biventricular and biatrial deformation indices in pGDM women. Accordingly, we aimed at investigating the structure and myocardial deformation properties of all cardiac chambers in a cohort of pGDM women, at 4 years post-partum. Methods: A consecutive cohort of pGDM women was compared to a control group of healthy women with previous uncomplicated pregnancy, matched by age, ethnicity and gestational week, at 4 years postpartum. Both groups of women underwent a conventional transthoracic echocardiography (TTE) implemented with complete analysis of biventricular and biatrial myocardial deformation indices by speckle tracking echocar-diography (STE). The primary endpoint was subclinical myocardial dysfunction, defined as left ventricular (LV) global longitudinal strain (GLS) magnitude 27 Kg/m2 and third trimester glycosylated hemoglobin >33 mmol/mol showed the best sensitivity and specificity for predicting both endpoints. Conclusions: Pregnant women with previous history of GDM complicated by overweight/obesity and uncontrolled diabetes have a significantly in-creased risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum.