INTRODUCTION
Gestational diabetes mellitus
(GDM) is variable degree of glucose intolerance that begins or is
recognized during pregnancy 1. Pregnant women with GDM
have an increased risk of developing type II diabetes mellitus (DM) and
cardiovascular disease in long-term follow-ups. Moreover, children of
mothers with a history of GDM are at risk of developing obesity and
metabolic syndrome in long-term follow-up 2. In
addition, some studies have shown subclinical atherosclerosis3, endothelial dysfunction 4, and
increased risk of cardiovascular disease in women with a history of GDM5,6. Diabetes also increases arrhythmic events by
causing an imbalance in autonomic tone, silent ischemia, heterogeneity
in atrial and ventricular repolarization, and direct myocardial damage
through increased arrhythmogenic substrates.
Atrial fibrillation (AF) is a
common arrhythmia in diabetic individuals 7.
Electrophysiological and electromechanical delays from intraatrial and
interatrial conduction disturbances are associated with an increased
risk of AF 8,9. The difference between the
maximum P-wave duration (P max)
and the minimum P-wave duration (P min) measured noninvasively from a
twelve-lead surface electrocardiogram (ECG) is called
P-wave dispersion (PWD), and PWD
has been found to be closely associated with the development of
paroxysmal AF 10. In recent years, the tissue Doppler
method has been used to evaluate intraatrial and interatrial conduction
times. Atrial EMD measured by this
method have been shown to be prolonged in patients with paroxysmal AF11. It has been suggested that atrial conduction times
may be disordered in diabetic patients 12. However, as
far as we know, atrial conduction times has not been studied in GDM
patients. The aim of our study is to investigate PWD and atrial
conduction times in patients with GDM.