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

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. 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. The funders had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. This study was partly supported by Ministerio de Economia y Competitividad (TIN2014-52923-R); Instituto de Salud Carlos III (PI11/01709, PI12/00801, PI14/00226, PI15/00263; PI15/00130) integrados en el Plan Nacional de I + D + I y cofinanciados por el ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER) “Otra manera de hacer Europa”; the EU-FP7 for research, technological development and demonstration under grant agreement VP2HF (no611823); The Cerebra Foundation for the Brain Injured Child (Carmarthen, UK); AGAUR 2014 SGR grant nº 928; additionally the research leading to these results has received funding from “la Caixa” Foundation. P.G.C. was supported by the Programa de Ayudas Predoctorales de Formación en investigación en Salud (FI12/00362) from the Instituto Carlos III, Spain. B.V.A. was supported by Programa de Ayudas Postdoctorales from Agència de Gestió d'Ajuts Universitaris i de Recerca [grant number: 2013FI_B 00667].