Natural history of left ventricular hypertrophy in infants of diabetic mothers.

This study sought to describe the characteristics and the natural course of left ventricular hypertrophy (LVH) in a well-characterized consecutive cohort of infants of diabetic mothers (IDMs). Sixty consecutive IDMs with LVH have been retrospectively identified and enrolled in the study. All IDMs were evaluated at baseline and every 6 months until LV wall thickness regression, defined as the decrease of wall thickness measurement into the normal reference range for cardiac parameters (z-score > −2 and < 2). A comprehensive assessment was performed in those patients with diagnostic markers suggestive of a different cause and/or without significant reduction of the LVH during follow-up. At 1-year follow-up, all IDMs showed a significant reduction of maximal wall thickness MWT (6.00 mm [IQR 5.00–712] vs. 5.50 mm [IQR 5.00–6.00], p-value <0.001; MWT-z-score: 4.86 [IQR 3.93–7.61] vs. 1.72 [IQR 1.08–2.85], p-value <0.001) compared to baseline, and all patients showed LV wall thickness regression or residual mild or moderate LVH (57%, 28%, and 12%, respectively), except 2 patients with persistent severe LVH, that after a comprehensive clinical-genetic assessment were diagnosed as Noonan syndrome with multiple lentigines. At multivariate analysis, MWT was negatively associated with LV wall thickness regression at 1-year follow-up (MWT-mm: OR 0.48[0.29–0.79], p-value = 0.004; MWT-z-score: OR 0.71[0.56–0.90], p-value = 0.004). LVH in IDMs represents a benign condition with complete regression during the first years of life. In those patients without LV wall thickness regression, combined with clinical markers suggesting a specific disease, a complete work-up is required for a definite diagnosis. [Display omitted] • 57% of IDMs showed left ventricular wall thickness regression in the first year of age. • Two IDMs with persistent severe LVH at 1-year follow-up were diagnosed as NSML. • All IDMs showed a LV wall thickness regression in the first 6 years of life. [ABSTRACT FROM AUTHOR]