BACKGROUND: Preterm birth leads to an early switch from fetal to postnatal circulation before completion of left ventricular in utero development. In animal studies, this results in an adversely remodeled left ventricle. We determined whether preterm birth is associated with a distinct left ventricular structure and function in humans. METHODS AND RESULTS: A total of 234 individuals 20 to 39 years of age underwent cardiovascular magnetic resonance. One hundred two had been followed prospectively since preterm birth (gestational age=30.3±2.5 week; birth weight=1.3±0.3 kg), and 132 were born at term to uncomplicated pregnancies. Longitudinal and short-axis cine images were used to quantify left ventricular mass, 3-dimensional geometric variation by creation of a unique computational cardiac atlas, and myocardial function. We then determined whether perinatal factors modify these left ventricular parameters. Individuals born preterm had increased left ventricular mass (66.5±10.9 versus 55.4±11.4 g/m(2); P<0.001) with greater prematurity associated with greater mass (r = -0.22, P=0.03). Preterm-born individuals had short left ventricles with small internal diameters and a displaced apex. Ejection fraction was preserved (P>0.99), but both longitudinal systolic (peak strain, strain rate, and velocity, P<0.001) and diastolic (peak strain rate and velocity, P<0.001) function and rotational (apical and basal peak systolic rotation rate, P =0.05 and P =0.006; net twist angle, P=0.02) movement were significantly reduced. A diagnosis of preeclampsia during the pregnancy was associated with further reductions in longitudinal peak systolic strain in the offspring (P=0.02, n=29). CONCLUSIONS: Individuals born preterm have increased left ventricular mass in adult life. Furthermore, they exhibit a unique 3-dimensional left ventricular geometry and significant reductions in systolic and diastolic functional parameters. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01487824.
BACKGROUND: Preterm birth leads to an early switch from fetal to postnatal circulation before completion of left ventricular in utero development. In animal studies, this results in an adversely remodeled left ventricle. We determined whether preterm birth is associated with a distinct left ventricular structure and function in humans. METHODS AND RESULTS: A total of 234 individuals 20 to 39 years of age underwent cardiovascular magnetic resonance. One hundred two had been followed prospectively since preterm birth (gestational age=30.3±2.5 week; birth weight=1.3±0.3 kg), and 132 were born at term to uncomplicated pregnancies. Longitudinal and short-axis cine images were used to quantify left ventricular mass, 3-dimensional geometric variation by creation of a unique computational cardiac atlas, and myocardial function. We then determined whether perinatal factors modify these left ventricular parameters. Individuals born preterm had increased left ventricular mass (66.5±10.9 versus 55.4±11.4 g/m(2); P<0.001) with greater prematurity associated with greater mass (r = -0.22, P=0.03). Preterm-born individuals had short left ventricles with small internal diameters and a displaced apex. Ejection fraction was preserved (P>0.99), but both longitudinal systolic (peak strain, strain rate, and velocity, P<0.001) and diastolic (peak strain rate and velocity, P<0.001) function and rotational (apical and basal peak systolic rotation rate, P =0.05 and P =0.006; net twist angle, P=0.02) movement were significantly reduced. A diagnosis of preeclampsia during the pregnancy was associated with further reductions in longitudinal peak systolic strain in the offspring (P=0.02, n=29). CONCLUSIONS: Individuals born preterm have increased left ventricular mass in adult life. Furthermore, they exhibit a unique 3-dimensional left ventricular geometry and significant reductions in systolic and diastolic functional parameters. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01487824.
Authors: Peter Ueda; Sven Cnattingius; Olof Stephansson; Erik Ingelsson; Jonas F Ludvigsson; Anna-Karin Edstedt Bonamy Journal: Eur J Epidemiol Date: 2014-04-01 Impact factor: 8.082
Authors: Genevieve Farrar; Avan Suinesiaputra; Kathleen Gilbert; James C Perry; Sanjeet Hegde; Alison Marsden; Alistair A Young; Jeffrey H Omens; Andrew D McCulloch Journal: Prog Pediatr Cardiol Date: 2016-08-18
Authors: Andrew M South; Hossam A Shaltout; Lisa K Washburn; Alexa S Hendricks; Debra I Diz; Mark C Chappell Journal: Clin Sci (Lond) Date: 2019-01-08 Impact factor: 6.124
Authors: Alexandra H Wallace; Stuart R Dalziel; Brett R Cowan; Alistair A Young; Kent L Thornburg; Jane E Harding Journal: Arch Dis Child Date: 2016-09-23 Impact factor: 3.791
Authors: Madeline H Knott; Sarah E Haskell; Payton E Strawser; Olivia M Rice; Natalie T Bonthius; Vani C Movva; Benjamin E Reinking; Robert D Roghair Journal: Anat Rec (Hoboken) Date: 2018-05-20 Impact factor: 2.064
Authors: Philip T Levy; Afif El-Khuffash; Meghna D Patel; Colm R Breatnach; Adam T James; Aura A Sanchez; Cristina Abuchabe; Sarah R Rogal; Mark R Holland; Patrick J McNamara; Amish Jain; Orla Franklin; Luc Mertens; Aaron Hamvas; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2017-04-19 Impact factor: 5.251
Authors: Wilby Williamson; Adam J Lewandowski; Nils D Forkert; Ludovica Griffanti; Thomas W Okell; Jill Betts; Henry Boardman; Timo Siepmann; David McKean; Odaro Huckstep; Jane M Francis; Stefan Neubauer; Renzo Phellan; Mark Jenkinson; Aiden Doherty; Helen Dawes; Eleni Frangou; Christina Malamateniou; Charlie Foster; Paul Leeson Journal: JAMA Date: 2018-08-21 Impact factor: 56.272