Changes in the Preterm Heart From Birth to Young Adulthood: A Meta-analysis

Telles, Fernando; McNamara, Nicholas; Nanayakkara, Shane; Doyle, Mathew; Williams, Michael L.; Yaeger, Lauren; Marwick, Thomas H.; Leeson, Paul; Levy, Philip; Lewandowski, Adam J.

doi:10.1542/peds.2020-0146

Cited by 83 publications

(95 citation statements)

References 72 publications

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“…The two authors of this paper independently assessed the methodological quality of included studies, using a 10-item modified scoring system to reflect favourable design, reporting, as well as attrition and compliance (Supplementary Table 2). (18)(19)(20) For each item, a score of 1 was allocated if the study met the criteria for that subcategory. Attrition and compliance criteria were based on standard guidelines for exercise intervention trials.…”

Section: Quality Assessmentmentioning

confidence: 99%

Physical activity modification in youth with congenital heart disease: a comprehensive narrative review

Deutekom

Lewandowski

2020

Pediatr Res

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Congenital heart disease (CHD) affects nearly 1% of births. As survival rates have dramatically improved, the majority of individuals with CHD now live into adulthood. As these patients age, they become prone to a large range of complications, such as chronic heart failure and acquired cardiovascular disease. Promotion of a healthy and active lifestyle from childhood onwards has been suggested as a sustainable and effective strategy to enhance cardiovascular health, improve quality of life and reduce immediate and long-term risk in people with CHD. Well-established physical activity consensus statements for youth with CHD have now been published. In this article, we review how increasing physical activity in youth with CHD may offer immediate and long-term cardiovascular benefits, what is known about physical activity in children with CHD, describe the unique factors that contribute to achieving sufficient and insufficient physical activity levels and summarize the evidence of trials on physical activity promotion in youth with CHD. Furthermore, we discuss some of the challenges that need to be addressed by further research regarding the optimal strategy, timing and format of physical activity intervention programmes in children and adolescents with CHD. Impact Congenital heart disease (CHD) affects nearly 1% of births, with the majority of individuals with CHD now living into adulthood due to improved survival. As CHD patients age, they become prone to a large range of cardiovascular complications.This article discusses how and why increasing physical activity in youth with CHD may offer immediate and long-term cardiovascular benefits, the barriers to achieving sufficient physical activity levels and the evidence from trials on physical activity promotion in youth with CHD.The optimal strategy, timing and format of physical activity intervention programmes in children and adolescents with CHD are discussed.

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Section: Quality Assessmentmentioning

confidence: 99%

Physical activity modification in youth with congenital heart disease: a comprehensive narrative review

Deutekom

Lewandowski

2020

Pediatr Res

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“…LBW has been consistently associated with increased adult cardiovascular mortality, hypertension, metabolic syndrome, diabetes and lung morbidity. 10,11,12,[15][16][17][18][19][20][21] LBW can be a result of being born too small -fetal growth restriction-and/or too early -prematurity-.…”

Section: Interpretation Of Novel Findingsmentioning

confidence: 99%

“…(which was not certified by peer review) preprint prematurity, key developmental stages have to take place ex utero in non-physiological conditions 39 leading to cardiovascular hypertrophy and impaired lung development, insulin sensitivity and bone density. [20][21][22]39…”

Section: Interpretation Of Novel Findingsmentioning

confidence: 99%

“…13 Fetal growth restriction has been associated with increased cardiovascular mortality, 10,15 lower lung functional capacity [16][17][18] and increased respiratory morbidity [18][19] in adulthood. Likewise, prematurity has been described as a risk factor for suboptimal cardiovascular 20 and lung 21 development and a greater predisposition to heart failure 22 and lung disease 23 later in life. For studies in adults, birth weight is an accessible and robust surrogate for fetal growth restriction and preterm births, and a strong predictor of short and long-term morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Low Birth Weight as a Risk Factor for Severe Covid-19 in Adults

Crispi

Crovetto

Larroya

et al. 2020

Preprint

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The identification of factors predisposing to severe COVID-19 in young adults remains partially characterized. Low birth weight (LBW) alters cardiovascular and lung development and predisposes to adult disease. We hypothesized that LBW is a risk factor for severe COVID-19 in non-elderly subjects. We analyzed a prospective cohort of 397 patients (18-70y) with laboratory-confirmed SARS-CoV-2 infection attended in a tertiary hospital, where 15% required admission to Intensive Care Unit (ICU). Perinatal and current potentially predictive variables were obtained from all patients and LBW was defined as birth weight ≤2,500 g. Age (adjusted OR (aOR) 1.04 [1-1.07], P=0.012), male sex (aOR 3.39 [1.72-6.67], P<0.001), hypertension (aOR 3.37 [1.69-6.72], P=0.001), and LBW (aOR 3.61 [1.55-8.43], P=0.003) independently predicted admission to ICU. The area under the receiver-operating characteristics curve (AUC) of this model was 0.79 [95% CI, 0.74-0.85], with positive and negative predictive values of 29.1% and 97.6% respectively. Results were reproduced in an independent cohort, from a web-based survey in 1,822 subjects who self-reported laboratory-positive SARS-CoV-2 infection, where 46 patients (2.5%) needed ICU admission (AUC 0.74 [95% CI 0.68-0.81]). LBW seems to be an independent risk factor for severe COVID-19 in non-elderly adults and might improve the performance of risk stratification algorithms.

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“… 7 The unique cardiac phenotype of premature infants is known to persist into childhood as a recent meta-analysis demonstrated that preterm-born individuals have persistently smaller ventricular dimensions, ongoing systolic and diastolic dysfunction that worsens with age, and an accelerated rate of LV hypertrophy from childhood to adulthood. 8 Our group has explored the natural progression of rotational mechanics in preterm infants immediately after birth, 1 but the interpretation of the results has been lacking without serial comparisons to term infants.…”

Section: Introductionmentioning

confidence: 99%

Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

et al. 2021

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ObjectiveLeft ventricle (LV) rotational mechanics is an emerging tool to characterise LV function, but warrants further evaluation in neonates. The aim of this study was to compare LV rotational mechanics between term and extremely preterm babies over the first week of age.MethodsIn this prospective study, we serially assessed LV rotational parameters in 50 term infants and compared them with a historical dataset of 50 preterm infants born <29 weeks gestation. LV basal and apical rotation, LV twist, LV twist/untwist rate and torsion were derived using two-dimensional speckle tracking echocardiography at three time points over the first week of age.ResultsThere was no change in LV twist, LV torsion, basal rotation or apical rotation in term infants over the study period (all p>0.05). LV twist and torsion were higher in preterm infants, and increased over time. In preterm infants, basal rotation evolved from anticlockwise to clockwise rotation. Apical rotation remained anticlockwise in both groups (all p>0.05). LV twist rate (LVTR) and untwist rate was higher in preterm infants and increased over the three time points (all p>0.05). There was a strong positive correlation between LV torsion and LV untwist rate (LVUTR) in the entire cohort during the third scan.ConclusionTerm infants exhibit minimal LV twist which remains unchanged over the first week of age. This is in contrast to premature infants who demonstrate increasing indices of twist, torsion, LVTR and LVUTR over the first week, likely as a compensatory mechanism for reduced LV compliance.

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Changes in the Preterm Heart From Birth to Young Adulthood: A Meta-analysis

Cited by 83 publications

References 72 publications

Physical activity modification in youth with congenital heart disease: a comprehensive narrative review

Physical activity modification in youth with congenital heart disease: a comprehensive narrative review

Low Birth Weight as a Risk Factor for Severe Covid-19 in Adults

Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

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