Skip to main content
SpringerLink
Log in

Prolonged QT Dispersion in the Infants of Diabetic Mothers

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Myocardial hypertrophy and cardiac dysfunction frequently occur in newborns of diabetic mothers. The authors hypothesized that wall hypertrophy or disproportionate left ventricular wall thickness in newborns of diabetic mothers may affect both QT and QTc dispersion. This study aimed to assess whether left ventricular hypertrophy affects the QT variables of infants born to diabetic mothers. This prospective cross-sectional study was conducted with 47 consecutively selected neonates of gestational diabetic mothers and 30 healthy neonates born to healthy mothers. All the subjects were evaluated during the neonatal period. Electrocardiography with echocardiography was performed for the patients and the control subjects. The newborns of the diabetic mothers were classified according to septal thickness as group 1 (16 newborns with septal hypertrophy) or group 2 (31 newborns without septal hypertrophy). The study group consisted of three cohorts: groups 1, 2, and 3 (control group). Both QT and QTc dispersion were computed from a randomly selected beat as well as from an average beat derived from 12 beats included in a 10-s electrocardiography. A total of 16 infants (34 %) had a septal thickness of 6 mm or greater. The left ventricular end-systolic diameter in group 1 was smaller (p = 0.0029) than in groups 2 and 3 (p = 0.003). The interventricular septal thickness at end diastole (IVSTd) and the left ventricular posterior wall thickness at end diastole in group 1 were higher than in of groups 2 and 3. The QT and QTc dispersion intervals were longer in group 1 than in groups 2 and 3 (p < 0.001), and a highly significant positive correlation was detected between IVSTd and QT dispersion (r = 0.514, p = 0.042). Elevated QT and QTc dispersions may be risk factors for the development of arrhythmias in newborns of diabetic mothers. These patients may critically need systematic cardiac screening.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aman J, Hansson U, Ostlund I, Wall K, Persson B (2011) Increased fat mass and cardiac septal hypertrophy in newborn infants of mothers with well-controlled diabetes during pregnancy. Neonatology 100:147–154

    Article  CAS  PubMed  Google Scholar 

  2. Badran HM, Elnoamany MF, Soltan G, Ezat M, Elsedi M, Abdelfatah RA, Yacoub M (2012) Relationship of mechanical dyssynchrony to QT interval prolongation in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 13:423–432

    Article  PubMed  Google Scholar 

  3. Bayrak F, Kahveci G, Mutlu B, Değertekin M, Demirtaş E (2007) Usefulness of surface electrocardiogram in predicting the clinical course of patients with hypertrophic cardiomyopathy. Anadolu Kardiyol Derg 7:178–181

    PubMed  Google Scholar 

  4. Boney CM, Verma A, Tucker R, Vohr BR (2005) Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 115:290–296

    Article  Google Scholar 

  5. Chu C, Gui YH, Ren YY, Shi LY (2012) The ımpacts of maternal gestational diabetes mellitus (GDM) on fetal hearts. Biomed Environ Sci 25:15–22

    PubMed  Google Scholar 

  6. Cooper MJ, Enderlein MA, Tarnoff H, Roge CL (1992) Asymmetric septal hypertrophy in infants of diabetic mothers: fetal echocardiography and the impact of maternal diabetic control. Am J Dis Child 146:1021–1022

    Article  Google Scholar 

  7. D’Andrea A, Caso P, Severino S, Cuomo S, Capozzi G, Calabro P et al (2006) Prognostic value of intra-left ventricular electromechanical asynchrony in patients with hypertrophic cardiomyopathy. Eur Heart J 27:1311–1318

    Article  PubMed  Google Scholar 

  8. El-Ganzoury MM, El-Masry SA, El-Farrash RA, Anwar M, Abd Ellatife RZ (2012) Infants of diabetic mothers: echocardiographic measurements and cord blood IGF-I and IGFBP-1. Pediatr Diabetes 13:189–196

    Article  CAS  PubMed  Google Scholar 

  9. Jaeggi ET, Fouron JC, Proulx F (2001) Fetal cardiac performance in uncomplicated and well-controlled maternal type I diabetes. Ultrasound Obstet Gynecol 17:311–315

    Article  CAS  PubMed  Google Scholar 

  10. Kaya CT, Gurlek A, Altin T, Kilickap M, Karabulut HG, Turhan S et al (2010) The relationship between angiotensin converting enzyme gene I/D polymorphism and QT dispersion in patients with hypertrophic cardiomyopathy. J Renin Angiotensin Aldosterone Syst 11:192–197

    Article  PubMed  Google Scholar 

  11. Krishnaveni GV, Hill JC, Leary SD, Veena SR, Saperia J, Saroja A, Karat SC, Fall CH (2005) Anthropometry, glucose tolerance, and insulin concentrations in Indian children: relationships to maternal glucose and insulin concentrations during pregnancy. Diabetes Care 28:2919–2925

    Article  CAS  PubMed  Google Scholar 

  12. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108

    Article  PubMed  Google Scholar 

  13. Lazzeri C, Barletta G, Badia T, Capalbio A, Del Bene R, Franchi F, Gensini GF, Michelucci A (2005) Multiparametric electrocardiographic evaluation of left ventricular hypertrophy in idiopathic and hypertensive cardiomyopathy. Ital Heart J 6:304–310

    PubMed  Google Scholar 

  14. Maron BJ, Leyhe MJ III, Casey SA, Gohman TE, Lawler CM, Crow RS, Maron MS, Hodges M (2001) Assessment of QT dispersion as a prognostic marker for sudden death in a regional nonreferred hypertrophic cardiomyopathy cohort. Am J Cardiol 87:114–115

    Article  CAS  PubMed  Google Scholar 

  15. Molnar J, Somberg JC (2009) QT dispersion: still a useful measurement. Cardiology 112:165–167

    Article  PubMed  Google Scholar 

  16. Pye M, Quinn AC, Cobbe SM (1994) QT interval dispersion: a noninvasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias? Br Heart J 71:511–514

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Ren Y, Zhou Q, Yan Y, Chu C, Gui Y, Li X (2011) Characterization of fetal cardiac structure and function detected by echocardiography in women with normal pregnancy and gestational diabetes mellitus. Prenat Diagn 31:459–465

    Article  PubMed  Google Scholar 

  18. Russell NE, Foley M, Kinsley BT, Firth RG, Coffey M, McAuliffe FM (2008) Effect of pregestational diabetes mellitus on fetal cardiac function and structure. Am J Obstet Gynecol 199:312

    PubMed  Google Scholar 

  19. Sakata K, Shimizu M, Ino H, Yamaguchi M, Terai H, Hayashi K et al (2003) QT dispersion and left ventricular morphology in patients with hypertrophic cardiomyopathy. Heart 89:882–886

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Yi G, Poloniecki J, Dickie S, Elliott PM, Malik M, McKenna WJ (2000) Can the assessment of dynamic QT dispersion on exercise electrocardiogram predict sudden cardiac death in hypertrophic cardiomyopathy? Pacing Clin Electrophysiol 23:1953–1956

    Article  CAS  PubMed  Google Scholar 

  21. Yi G, Poloniecki J, Dickie S, Elliott PM, Malik M, McKenna WJ (2001) Is QT dispersion associated with sudden cardiac death in patients with hypertrophic cardiomyopathy? Ann Noninvasive Electrocardiol 6:209–215

    Article  CAS  PubMed  Google Scholar 

  22. Zaidi M, Robert A, Fesler R, Derwael C, Brohet C (1996) Dispersion of ventricular repolarization in hypertrophic cardiomyopathy. J Electrocardiol 29:89–94

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology, Selcuk University Medical Faculty, 42075, Konya, Turkey

    Derya Arslan, Osman Guvenc, Derya Cimen & Bulent Oran

  2. Department of Family Physician, Selcuk University Medical Faculty, Konya, Turkey

    Havva Ulu

Authors
  1. Derya Arslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osman Guvenc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Derya Cimen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Havva Ulu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bulent Oran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Derya Arslan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arslan, D., Guvenc, O., Cimen, D. et al. Prolonged QT Dispersion in the Infants of Diabetic Mothers. Pediatr Cardiol 35, 1052–1056 (2014). https://doi.org/10.1007/s00246-014-0897-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-014-0897-3

Keywords

Search

Navigation