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2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing fetal heart development but they warrant revalidation and adjustment. 377 normal fetuses with healthy mothers, 98 normal fetuses with diabetic mothers, and 37 fetuses with cardiomyopathy and diabetic mothers had their cardiac structural dimensions, cardiothoracic ratio, valve flow velocities, and heart rates measured by fetal ECHO in a retrospective chart review. Cardiac features were fitted to linear functions, with respect to gestational age, femur length, head circumference, and biparietal diameter and z-scores were created to model normal fetal growth for all parameters. These z-scores were used to assess what metrics had no difference in means between the normal fetuses of both healthy and diabetic mothers, but differed from those diagnosed with cardiomyopathy. It was found that functional metrics like mitral and tricuspid E wave and pulmonary velocity could be important predictors for cardiomyopathy when fitted by gestational age, femur length, head circumference, and biparietal diameter. Additionally, aortic and tricuspid annulus diameters when fitted to estimated gestational age showed potential to be predictors for fetal cardiomyopathy. While the metrics overlapped over their full range, combining them together may have the potential for predicting cardiomyopathy in utero. Future directions of this study will explore creating a classifier model that can predict cardiomyopathy using the metrics assessed in this study.
Methods: Three databases were used to search for papers published after 2010 until October 2019 discussing obesity, overweight and TCM. No forms of Chinese medicine were excluded from the search. Studies were excluded if they did not meet the date criteria or if they overlapped with papers found in other databases.
Results: Six of the selected papers covered acupuncture (electro, balance or catgut embedding acupuncture methods) either jointly with other treatments or alone, one exclusively on moxibustion and three studies on three different types of TCM herbal medicine. Each study showed a statistically significant effect on body mass index (BMI) value decrease or total weight loss (TWL). The six acupuncture papers all showed statistical significance at the 95% CI against control groups (sham acupuncture or no acupuncture) and against before-treatment BMI values or TWL values.
Conclusion: Of the treatments reviewed, almost all acupuncture studies were shown to be consistently effective in treating overweight or obese individuals within this selection of studies, as well as in another meta-analysis. This may be due to acupuncture’s ties to a neuroendocrine mechanism. Future studies should further explore the neuroendocrine connection between acupuncture and weight loss. Herbal medication was also shown to have a significant effect in reducing weight in each study; however, two studies used mice or rats as subjects, therefore understanding the effects on human subjects is limited.