Maladaptive structural remodelling of the heart following preterm birth

Lê, Bianca; Sutherland, Megan R.; Black, Mary Jane

doi:10.1016/j.cophys.2017.08.004

Cited by 7 publications

(3 citation statements)

References 66 publications

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“…Preterm birth is associated with structural remodelling of the cardiovascular system (Le, Sutherland, & Black, 2018; Norman, 2008) and it has been proposed that this may arise as compensatory adaptations of the immature cardiovascular system to the premature exposure to postnatal life. Notably, in the present study there were few differences in the vascular structure, wall composition and blood flow measurements of large conduit arteries at postnatal day 2 between lambs that were born moderately preterm and those born at term.…”

Section: Discussionmentioning

confidence: 99%

Early impact of moderate preterm birth on the structure, function and gene expression of conduit arteries

Lombardo

Nguyen

Flores

et al. 2020

Experimental Physiology

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The aim of this work was to compare the structure and function of the conduit arteries of moderately preterm and term-born lambs and to determine whether vascular injuryassociated genes were upregulated. Time-mated ewes were induced to deliver either preterm (132 ± 1 days of gestation; n = 11 females and n = 10 males) or at term (147 ± 1 days of gestation; n = 10 females and n = 5 males). Two days after birth, ultrasound imaging of the proximal ascending aorta, main, right and left pulmonary arteries, and right and left common carotid arteries was conducted in anaesthetized lambs. Lambs were then killed and segments of the thoracic aorta and left common carotid artery were either snap frozen for real-time PCR analyses or immersion-fixed for histological quantification of collagen, smooth muscle and elastin within the medial layer. Overall there were few differences in vascular structure between moderately preterm and term lambs. However, there was a significant decrease in the proportion of collagen within the thoracic aortic wall (predominantly in males), narrowing of the common carotid arteries and a reduction in peak aortic systolic blood flow in preterm lambs. In addition, there was increased mRNA expression of the cell adhesion marker P-selectin in the thoracic aortic wall and the pro-inflammatory marker IL-1β in the left common carotid artery in preterm lambs, suggestive of postnatal vascular injury. Early postnatal differences in the function and structure of conduit arteries and evidence of vascular injury in moderately preterm offspring may place them at greater risk of cardiovascular impairment later in life.

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Section: Discussionmentioning

confidence: 99%

Early impact of moderate preterm birth on the structure, function and gene expression of conduit arteries

Lombardo

Nguyen

Flores

et al. 2020

Experimental Physiology

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“…2017 ), with differences in cardiac structure and function persisting in adulthood (reviewed in Bensley et al . 2016 , Le et al . 2018 ).…”

Section: The Heart In Preterm Infantsmentioning

confidence: 99%

Glucocorticoids, antenatal corticosteroid therapy and fetal heart maturation

Agnew

Ivy

Stock

et al. 2018

Journal of Molecular Endocrinology

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Glucocorticoids are essential in mammals to mature fetal organs and tissues in order to survive after birth. Hence, antenatal glucocorticoid treatment (termed antenatal corticosteroid therapy) can be life-saving in preterm babies and is commonly used in women at risk of preterm birth. While the effects of glucocorticoids on lung maturation have been well described, the effects on the fetal heart remain less clear. Experiments in mice have shown that endogenous glucocorticoid action is required to mature the fetal heart. However, whether the potent synthetic glucocorticoids used in antenatal corticosteroid therapy have similar maturational effects on the fetal heart is less clear. Moreover, antenatal corticosteroid therapy may increase the risk of cardiovascular disease in adulthood. Here, we present a narrative review of the evidence relating to the effects of antenatal glucocorticoid action on the fetal heart and discuss the implications for antenatal corticosteroid therapy.

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“…Adults born preterm are at increased risk of developing cardiac dysfunction later in life (Carr, Cnattingius, Granath, Ludvigsson, & Edstedt Bonamy, 2017; Crump et al, 2019; Crump, Winkleby, Sundquist, & Sundquist, 2011; de Jong, Monuteaux, van Elburg, Gillman, & Belfort, 2012; Kowalski et al, 2016; Skudder‐Hill, Ahlsson, Lundgren, Cutfield, & Derraik, 2019), which may be linked to abnormal postnatal remodeling of the preterm heart (Le, Sutherland, & Black, 2018). Functional MRI studies show that young adults born preterm have impaired LV systolic and diastolic function, which is associated with abnormal LV morphology (Kowalski et al, 2016; Lewandowski et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Microarchitecture of the hearts in term and former‐preterm lambs using diffusion tensor imaging

Lê

Ferreira

Merchant

et al. 2020

The Anatomical Record

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Diffusion tensor imaging (DTI) is an MRI technique that can be used to map cardiomyocyte tracts and estimate local cardiomyocyte and sheetlet orientation within the heart. DTI measures diffusion distances of water molecules within the myocardium, where water diffusion generally occurs more freely along the long axis of cardiomyocytes and within the extracellular matrix, but is restricted by cell membranes such that transverse diffusion is limited. DTI can be undertaken in fixed hearts and it allows the three‐dimensional mapping of the cardiac microarchitecture, including cardiomyocyte organization, within the whole heart. The objective of this study was to use DTI to compare the cardiac microarchitecture and cardiomyocyte organization in archived fixed left ventricles of lambs that were born either preterm (n = 5) or at term (n = 7), at a postnatal timepoint equivalent to about 6 years of age in children. Although the findings support the feasibility of retrospective DTI scanning of fixed hearts, several hearts were excluded from DTI analysis because of poor scan quality, such as ghosting artifacts. The preliminary findings from viable DTI scans (n = 3/group) suggest that the extracellular compartment is altered and that there is an immature microstructural phenotype early in postnatal life in the LV of lambs born preterm. Our findings support a potential time‐efficient imaging role for DTI in detecting abnormal changes in the microstructure of fixed hearts of former‐preterm neonates, although further investigation into factors that affect scan quality is required.

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Maladaptive structural remodelling of the heart following preterm birth

Cited by 7 publications

References 66 publications

Early impact of moderate preterm birth on the structure, function and gene expression of conduit arteries

Early impact of moderate preterm birth on the structure, function and gene expression of conduit arteries

Glucocorticoids, antenatal corticosteroid therapy and fetal heart maturation

Microarchitecture of the hearts in term and former‐preterm lambs using diffusion tensor imaging

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