{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:17:04Z","timestamp":1767791824037,"version":"3.49.0"},"reference-count":26,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,8,19]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence regarding cardiovascular adaptation to pregnancy in women with pregestational diabetes is limited. Our study aimed to describe left ventricular (LV) remodelling and vascular adaptation to pregnancy in women with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cohort study, three consecutive cardiac MRI scans were conducted on age-matched and BMI-matched pregnant women with pregestational type 1 diabetes and pregnant women without diabetes. The scans were performed at gestational weeks 15\u201320, 26\u201330 and 34\u201337 from November 2020 to April 2023. Data collection and analysis included LV imaging results, brachial blood pressure and stroke volume derived functional vascular parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 24 women with pregestational type 1 diabetes and 39 controls. Compared with controls, women with type 1 diabetes had significantly reduced LV end-diastolic volume index: 64.2\u00b111.1 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      vs 77.6\u00b113.9 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      (p&lt;0.001), reduced end-systolic volume index: 26.0\u00b17.3 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      vs 33.5\u00b17.7 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      (p=0.003), increased concentricity: 0.84\u00b10.13 g\/mL vs 0.68\u00b10.10 g\/mL (p&lt;0.001), reduced stroke volume index: 38.2\u00b17.2 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      vs 44.1\u00b18.4 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      (p=0.008), reduced cardiac index: 3.37\u00b10.55 L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      vs 3.62\u00b10.51 L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      (p=0.046), reduced global longitudinal strain: \u221213.5\u00b12.3% vs \u221215.2\u00b12.1% (p=0.04), increased myocardial T1 values: 998\u00b128 ms vs 983\u00b125 ms (p=0.03), increased systolic blood pressure: 128.1\u00b17.8 mmHg vs 117.4\u00b111.1 mmHg (p=0.007), increased mean arterial pressure: 94.8\u00b16.7 mmHg vs 88.1\u00b19.7 mmHg (p=0.03), increased total peripheral vascular resistance: 28.9\u00b15.3 mmHg\u00b7min\u00b7m\n                      <jats:sup>2<\/jats:sup>\n                      \/L vs 24.7\u00b14.0 mmHg\u00b7min\u00b7m\n                      <jats:sup>2<\/jats:sup>\n                      \/L (p=0.001), and reduced total arterial compliance: 0.79\u00b10.19 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/mmHg vs 1.02\u00b10.21 mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/mmHg (p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study provides evidence of impaired LV remodelling and suboptimal vascular adaptation to pregnancy in women with type 1 diabetes when compared to women without diabetes. The clinical implications of these findings, particularly their association with the development of later cardiovascular disease, require further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003427","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T13:30:15Z","timestamp":1757079015000},"page":"e003427","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Left ventricular remodelling and vascular adaptation to pregnancy in women with type 1 diabetes"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04801121","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2058-0440","authenticated-orcid":false,"given":"\u00c1sa Wraae","family":"Olsen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2191-4138","authenticated-orcid":false,"given":"Anne N\u00f8dgaard Weidemann","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Randers Regional Hospital, Randers, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5408-2684","authenticated-orcid":false,"given":"Sidsel Linneberg","family":"Rathcke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9756-8705","authenticated-orcid":false,"given":"Trine Tang","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8722-0070","authenticated-orcid":false,"given":"Jens Br\u00f8ndum","family":"Fr\u00f8kj\u00e6r","sequence":"additional","affiliation":[{"name":"Department of Radiology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7441-0630","authenticated-orcid":false,"given":"Peter","family":"S\u00f8gaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6365-6638","authenticated-orcid":false,"given":"Tomas","family":"Zaremba","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Aalborg, 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