Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.

AIMS: Myocardial structural and functional abnormalities are known to occur in fetuses of mothers with diabetes mellitus (FMDM). The main aim of this investigation was to explore the cardiovascular circulatory patterns in FMDM using a validated lumped computational model of the cardiovascular system...

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Autores: Kulkarni, Aparna, Garcia-Canadilla, Patricia, Khan, Abdullah, Lorenzo, Jose Miguel, Beckerman, Karen, Valenzuela Alcaraz, Brenda I., Cruz Lemini, Mónica Cristina, Gomez, Olga, Gratacós Solsona, Eduard, Crispi Brillas, Fàtima, Bijnens, Bart
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2018
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/123435
Acceso en línea:https://hdl.handle.net/2445/123435
Access Level:acceso abierto
Palabra clave:Sistema cardiovascular
Ecografia Doppler
Diabetis en l'embaràs
Complicacions en l'embaràs
Neonatologia
Cardiovascular system
Doppler ultrasonography
Diabetes in pregnancy
Complications of pregnancy
Neonatology
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spelling Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.Kulkarni, AparnaGarcia-Canadilla, PatriciaKhan, AbdullahLorenzo, Jose MiguelBeckerman, KarenValenzuela Alcaraz, Brenda I.Cruz Lemini, Mónica CristinaGomez, OlgaGratacós Solsona, EduardCrispi Brillas, FàtimaBijnens, BartSistema cardiovascularEcografia DopplerDiabetis en l'embaràsComplicacions en l'embaràsNeonatologiaCardiovascular systemDoppler ultrasonographyDiabetes in pregnancyComplications of pregnancyNeonatologyAIMS: Myocardial structural and functional abnormalities are known to occur in fetuses of mothers with diabetes mellitus (FMDM). The main aim of this investigation was to explore the cardiovascular circulatory patterns in FMDM using a validated lumped computational model of the cardiovascular system. METHODS: This was a multi-institutional study involving FMDM compared to fetuses of maternal controls (FC). Fetal echocardiographic Doppler data from left and right ventricular outflow tracts, aortic isthmus, middle cerebral and umbilical arteries were fitted into a validated fetal circulation computational model to estimate patient-specific placental and vascular properties. Non-parametric comparisons were made between resistances, compliances and flows in the brain and placenta in FMDM and FC. RESULTS: Data from 23 FMDM and 31 FC were fitted into the model. In FMDM, compared to FC, placental relative resistance was lower (0.59 ± 0.50 versus 0.91 ± 0.41; p < .05) with higher brain relative resistance (2.36 ± 1.65 versus 1.60 ± 0.85; p < .05). Middle cerebral artery flow was lower in FMDM than FC (0.12 ± 0.14 vs. 0.27 ± 0.21 ml/min; p 0.04) with a lower cerebral-placental flow ratio. Combined stroke volume was lower in FMDM (3.65 ± 2.05 ml) than FC (4.97 ± 2.45 ml) (p 0.04). CONCLUSIONS: Blood flow is redistributed in FMDM to the placenta, away from the brain. This alteration may play a role in the postnatal health of these fetuses.Elsevier2018201920182018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion26 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/123435Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.1016/j.placenta.2017.12.020Placenta, 2018, vol. 63, p. 1-6https://doi.org/10.1016/j.placenta.2017.12.020info:eu-repo/grantAgreement/EC/FP7/611823cc-by-nc-nd (c) International Federation of Placenta Associations , 2018http://creativecommons.org/licenses/by-nc-nd/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1234352026-05-29T05:05:01Z
dc.title.none.fl_str_mv Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
title Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
spellingShingle Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
Kulkarni, Aparna
Sistema cardiovascular
Ecografia Doppler
Diabetis en l'embaràs
Complicacions en l'embaràs
Neonatologia
Cardiovascular system
Doppler ultrasonography
Diabetes in pregnancy
Complications of pregnancy
Neonatology
title_short Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
title_full Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
title_fullStr Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
title_full_unstemmed Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
title_sort Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.
dc.creator.none.fl_str_mv Kulkarni, Aparna
Garcia-Canadilla, Patricia
Khan, Abdullah
Lorenzo, Jose Miguel
Beckerman, Karen
Valenzuela Alcaraz, Brenda I.
Cruz Lemini, Mónica Cristina
Gomez, Olga
Gratacós Solsona, Eduard
Crispi Brillas, Fàtima
Bijnens, Bart
author Kulkarni, Aparna
author_facet Kulkarni, Aparna
Garcia-Canadilla, Patricia
Khan, Abdullah
Lorenzo, Jose Miguel
Beckerman, Karen
Valenzuela Alcaraz, Brenda I.
Cruz Lemini, Mónica Cristina
Gomez, Olga
Gratacós Solsona, Eduard
Crispi Brillas, Fàtima
Bijnens, Bart
author_role author
author2 Garcia-Canadilla, Patricia
Khan, Abdullah
Lorenzo, Jose Miguel
Beckerman, Karen
Valenzuela Alcaraz, Brenda I.
Cruz Lemini, Mónica Cristina
Gomez, Olga
Gratacós Solsona, Eduard
Crispi Brillas, Fàtima
Bijnens, Bart
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Sistema cardiovascular
Ecografia Doppler
Diabetis en l'embaràs
Complicacions en l'embaràs
Neonatologia
Cardiovascular system
Doppler ultrasonography
Diabetes in pregnancy
Complications of pregnancy
Neonatology
topic Sistema cardiovascular
Ecografia Doppler
Diabetis en l'embaràs
Complicacions en l'embaràs
Neonatologia
Cardiovascular system
Doppler ultrasonography
Diabetes in pregnancy
Complications of pregnancy
Neonatology
description AIMS: Myocardial structural and functional abnormalities are known to occur in fetuses of mothers with diabetes mellitus (FMDM). The main aim of this investigation was to explore the cardiovascular circulatory patterns in FMDM using a validated lumped computational model of the cardiovascular system. METHODS: This was a multi-institutional study involving FMDM compared to fetuses of maternal controls (FC). Fetal echocardiographic Doppler data from left and right ventricular outflow tracts, aortic isthmus, middle cerebral and umbilical arteries were fitted into a validated fetal circulation computational model to estimate patient-specific placental and vascular properties. Non-parametric comparisons were made between resistances, compliances and flows in the brain and placenta in FMDM and FC. RESULTS: Data from 23 FMDM and 31 FC were fitted into the model. In FMDM, compared to FC, placental relative resistance was lower (0.59 ± 0.50 versus 0.91 ± 0.41; p < .05) with higher brain relative resistance (2.36 ± 1.65 versus 1.60 ± 0.85; p < .05). Middle cerebral artery flow was lower in FMDM than FC (0.12 ± 0.14 vs. 0.27 ± 0.21 ml/min; p 0.04) with a lower cerebral-placental flow ratio. Combined stroke volume was lower in FMDM (3.65 ± 2.05 ml) than FC (4.97 ± 2.45 ml) (p 0.04). CONCLUSIONS: Blood flow is redistributed in FMDM to the placenta, away from the brain. This alteration may play a role in the postnatal health of these fetuses.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018
2018
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/123435
url https://hdl.handle.net/2445/123435
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.placenta.2017.12.020
Placenta, 2018, vol. 63, p. 1-6
https://doi.org/10.1016/j.placenta.2017.12.020
info:eu-repo/grantAgreement/EC/FP7/611823
dc.rights.none.fl_str_mv cc-by-nc-nd (c) International Federation of Placenta Associations , 2018
http://creativecommons.org/licenses/by-nc-nd/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) International Federation of Placenta Associations , 2018
http://creativecommons.org/licenses/by-nc-nd/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 26 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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