Key result
Preterm birth is linked to a ~7% lower exercise LVEF compared to term-born controls.
Why the study?
Prematurity leads to altered LV structure and function with preserved resting EF, but its impact on LV functional response to exercise stress is unclear.
Does preterm birth impair left ventricular functional response to physical exercise stress in young adults?
Population
101 normotensive young adults including 47 preterm-born and 54 term-born
Comparison
Preterm-born adults vs term-born adults during exercise stress at 40%, 60%, and 80% peak capacity
Design
Observational study with resting and exercise stress echocardiography
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Thanks to advances in modern medicine, there are a huge number of people alive today who were born prematurely. But we're only just beginning to understand the impact this start in life has on the heart. By unpicking the mechanisms that link premature birth to heart failure, we hope to develop strategies to keep this population healthier for longer.”
“Neither expecting parents, nor people who know they were born prematurely should let these findings worry them. Most babies born prematurely will live long and active lives, and won't go on to develop heart failure as adults. But the results do shed light on the way our hearts develop and how this could be different if you're born prematurely. The research also offers us new ideas for how we can help these people to protect their hearts for a lifetime.”
“Many factors contribute to our overall heart health. In recent decades, we have learned a good deal more about some factors like blood pressure and family history. We know less about how preterm birth relates to heart health and are trying to change that through our research.”
May warrant exercise caution in preterm-born adults; leaves open whether reduced reserve predicts future heart failure.
Case-Control (n=101)
Single-blind
No
Does preterm birth impair left ventricular functional response to physical exercise stress in young adults?
Mean Difference: -6.7
Absolute Event Rate: 71.9% vs 78.6%
p-value: p=0.004
Preterm-born young adults exhibit an impaired left ventricular systolic response to physical exercise despite preserved resting function, suggesting reduced myocardial reserve that may contribute to early heart failure risk.
Huckstep et al. (2018) conducted a case-control in Preterm birth (n=101). Preterm birth vs. Term birth was evaluated on Left ventricular ejection fraction at 60% exercise intensity (MD -6.7%, p=0.004). Preterm-born young adults exhibited an impaired left ventricular functional response to physical exercise, with ejection fraction dropping 6.7% below term-born controls at 60% exercise intensity (p=0.004).
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