Preterm birth was associated with increased left ventricular mass in adulthood (66.5 vs 55.4 g/m2; P<0.001) and significant reductions in systolic and diastolic functional parameters.
Cohort (n=234)
Does preterm birth alter left ventricular structure and function in adult life compared to term birth?
Preterm birth is associated with adverse left ventricular remodeling and subclinical myocardial dysfunction in young adulthood.
Absolute Event Rate: 66.5% vs 55.4%
p-value: p=<0.001
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); P0.99), 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.
Lewandowski et al. (Thu,) conducted a cohort in Preterm birth (n=234). Preterm birth vs. Term birth to uncomplicated pregnancies was evaluated on Left ventricular mass (g/m2) (p=<0.001). Preterm birth was associated with increased left ventricular mass in adulthood (66.5 vs 55.4 g/m2; P<0.001) and significant reductions in systolic and diastolic functional parameters.