{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T04:11:34Z","timestamp":1754107894182,"version":"3.41.2"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Gestational diabetes mellitus (GDM) is a transient metabolic disorder associated with hyperglycemia, insulin resistance, and endothelial dysfunction. Although GDM typically resolves after delivery, it can have long\u2010term effects on both maternal and fetal health, including potential cardiovascular complications for the offspring. This study aims to evaluate the impact of maternal hyperglycemia on fetal cardiac function using advanced fetal HQ (fetal heart quantification) imaging technology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study was conducted from July 2019 to November 2024, involving 303 pregnant women in their second and third trimesters, including 105 with GDM (well\u2010controlled) and 198 healthy controls. Fetal cardiac function was assessed using fetal HQ imaging, a two\u2010dimensional speckle\u2010tracking echocardiography technique. Measurements of global longitudinal strain (GLS), fractional area change (FAC), and fractional shortening (FS) were obtained for both the left (LV) and right (RV) ventricles. Correlations between maternal metabolic factors (BMI, HbA1c, triglycerides) and fetal cardiac parameters were also evaluated. Intra\u2010 and inter\u2010rater reliability were assessed for all measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The GDM group exhibited significantly lower LV GLS compared to the control group (\u221221.5 \u00b1\u00a05.5%\u00a0vs. \u221224.5 \u00b1\u00a04.9%, <jats:italic>p<\/jats:italic> = 0.000), indicating impaired myocardial deformation. No significant differences were found in RV GLS, FAC, or ejection fraction (EF). Significant differences in 24\u2010segment FS values were observed in both the LV and RV, with the GDM group showing lower FS values across most segments, suggesting subclinical myocardial dysfunction. Reliability analysis demonstrated high intra\u2010 and inter\u2010rater consistency for fetal cardiac measurements, with LV GLS showing excellent intra\u2010rater reliability (ICC = 0.912) and strong inter\u2010rater reliability (ICC = 0.725). HbA1c and triglycerides were negatively correlated with LV FAC, indicating that maternal metabolic factors may affect fetal left ventricular function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that GDM is associated with impaired fetal left ventricular function, particularly in myocardial deformation, as measured by LV GLS and FS. Maternal metabolic factors, including HbA1c and triglycerides, are linked to these alterations. Fetal HQ imaging is a reliable method for assessing fetal cardiac function and provides valuable insights into the cardiovascular effects of maternal hyperglycemia on the fetus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.70156","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T10:34:51Z","timestamp":1744367691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comprehensive Quantification of Fetal Cardiac Function in Gestational Diabetes Mellitus Using Advanced Fetal HQ Imaging Techniques"],"prefix":"10.1111","volume":"42","author":[{"given":"Jing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wujuan","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4756-5388","authenticated-orcid":false,"given":"Hong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Xiangyang Central Hospital Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei P.R. 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