Cardiac dysfunction during exercise in young adults with bronchopulmonary dysplasia

Abstract

BackgroundWorldwide, 1–2% of children is born premature and at risk for developing bronchopulmonary dysplasia (BPD). Preterm born adults are at risk for early cardiovascular disease. The role of BPD is unclear.AimThis study aims to examine cardiorespiratory function during submaximal exercise in young adult survivors of extreme prematurity, with or without BPD.MethodsForty premature born young adults, 20 with BPD (median[IQR] gestational age (GA), 27 [26–28] weeks) and 20 without BPD (GA age 28 [27–29] weeks) were prospectively compared to age-matched at term born (AT) adults (GA 39 [38–40] weeks). Participants underwent exercise testing and cardiovascular magnetic resonance (CMR) with submaximal exercise.ResultsResting heart rate in BPD subjects was higher than in AT born subjects (69±10versus61±7 mL, p=0.01). Peak oxygen uptake at maximal CPET was decreased in BPD patients (91±18versus106±17% of predicted, p=0.01). In BPD subjects cardiac stroke volume (SV) change with exercise was impaired compared to AT subjects (11±13%versus25±10%; p<0.001). With exercise, left ventricular end-diastolic volume decreased more in preterm borns withversuswithout BPD (−10±8%versus−3±8%; p=0.01) and compared to AT subjects (0±5%; p<0.001). Exploratory data analysis revealed that exercise SV and end-diastolic volume change were inversely correlated with oxygen dependency in those born prematurely.ConclusionsIn preterm born young adults –particularly those with BPD– resting cardiac function, exercise performance and cardiac response to exercise is impaired compared to controls. Exercise CMR may reveal an important predisposition for heart disease later in life.