Left Ventricle Structure and Function in Young Adults Born Very Preterm and Association with Neonatal Characteristics

Abstract

Preterm birth increases risk of cardiovascular disease and early death. A body of evidence suggests left ventricle (LV) echocardiographic alterations in children and adults born preterm. We aimed to determine if neonatal characteristics were associated with alterations in LV structure and function in preterm adults. We evaluated a cohort of 86 young adults born preterm below 30 weeks of gestation, and 85 full-term controls. We determined LV dimensions and function using tissue Doppler imaging, conventional and speckle tracking echocardiography (STE). Adults born preterm had smaller LV dimensions, but these differences did not remain after adjustment for body surface area (BSA), which was smaller in the preterm group. Stroke volume and cardiac output were reduced even after adjustment for BSA. We found a smaller e’ wave in the preterm group, but other markers of systolic and diastolic function did not differ. Use of antenatal steroids may be associated with a further reduced cardiac output in those born preterm. Adults born preterm show alterations in markers of LV dimensions and function. Identification of these markers may represent opportunities for early prevention of cardiovascular events in this at-risk population.

Cardiac Left Ventricle Mitochondrial Dysfunction After Neonatal Exposure to Hyperoxia: Relevance for Cardiomyopathy After Preterm Birth

“…These reports showed either no difference, increased risk of disease for males, or increased risk for females depending on the outcome examined. 58,59 Clinical papers from our group previously showed no sex-based difference between preterm and term individuals on overall cardiovascular risk factors, on the left ventricle 20 and the right ventricle 60 and on hemoglobin levels. 61 Nevertheless, in the clinical part of our study, both men and women were evaluated and although the lack of power prevent us to perform statistical analyses of sex-stratified results, humanin serum levels were similarly lower in preterm versus term for both males and females.…”

“…Our results suggest that mitochondrial dysfunction is present in preterm-born adults and that these alterations may be related to left ventricular systolic function. Because left ventricle ejection fraction and left ventricle systolic deformation by speckle-tracking echocardiography were within normal range for most participants, 20 we cannot extrapolate current results to diseased states. How left ventricle systolic function in preterm individuals will evolve with aging and associated age-related risk factors, and whether serum humanin could be used to predict risk of heart disease, remain to be determined.…”

“…Data were obtained from the HAPI (Health of Adults Born Preterm Investigation) cohort, which has been previously described. 20 , 21 We evaluated young adults aged 18 to 29 years, born in 1987 to 1997 at <30 weeks’ gestation, and compared them to peers matched for age but born full-term at ≥37 weeks’ gestation. Echocardiography was performed with a Vivid E9 ultrasound machine (GE Healthcare, Milwaukee).…”

“…We examined cardiac tissue samples from rats with OIC for mitochondrial changes and compared them to those of normal rats. To translate to the clinical context, we compared serum humanin levels in our cohort of young adults born very preterm to those of age-matched term-born adults, 20 , 21 and assessed the association of humanin with left ventricle ejection fraction.…”

World Prematurity Day: the long journey of the preterm lung

“…Examining the records of all individuals born in Sweden between 1973 and 1994, Crump et al (9) demonstrated that gestational age is inversely correlated with the incidence of ischemic heart diseases , and that cardiometabolic changes may predispose to the development of ischemic heart disease later in life. In addition, Flahault et al (13) demonstrated that preterm birth adult survivors frequently show alterations in left ventricular structure and function markers.…”