Physiological stress elicits impaired left ventricular function in preterm-born adults
<strong>Background</strong> Experimental and clinical studies show that prematurity leads to altered left ventricular (LV) structure and function with preserved resting LV ejection fraction (EF). Large-scale epidemiological data now links prematurity to increased early heart failure risk...
| Autores principales: | , , , , , , , , , , , , , |
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| Formato: | Journal article |
| Publicado: |
Elsevier
2018
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| _version_ | 1826261533486743552 |
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| author | Huckstep, OJ Williamson, W Telles, F Burchert, H Bertagnolli, M Herdman, C Arnold, L Smillie, R Mohamed, A Boardman, H McCormick, K Neubauer, S Leeson, P Lewandowski, AJ |
| author_facet | Huckstep, OJ Williamson, W Telles, F Burchert, H Bertagnolli, M Herdman, C Arnold, L Smillie, R Mohamed, A Boardman, H McCormick, K Neubauer, S Leeson, P Lewandowski, AJ |
| author_sort | Huckstep, OJ |
| collection | OXFORD |
| description | <strong>Background</strong> Experimental and clinical studies show that prematurity leads to altered left ventricular (LV) structure and function with preserved resting LV ejection fraction (EF). Large-scale epidemiological data now links prematurity to increased early heart failure risk. <strong>Objectives</strong> Echocardiography imaging was performed at prescribed exercise intensities to determine whether preterm-born adults have impaired LV functional response to physical exercise. <strong>Methods</strong> A total of 101 normotensive young adults born preterm (n = 47; mean gestational age 32.8 ± 3.2 weeks) and term (n = 54) were recruited for detailed cardiovascular phenotyping. Full clinical resting and exercise stress echocardiograms were performed, with apical 4-chamber views collected while exercising at 40%, 60%, and 80% of peak exercise capacity, determined by maximal cardiopulmonary exercise testing. <strong>Results</strong> Preterm-born individuals had greater LV mass (p = 0.015) with lower peak systolic longitudinal strain (p = 0.038) and similar EF to term-born control subjects at rest (p = 0.62). However, by 60% exercise intensity, EF was 6.7% lower in preterm subjects (71.9 ± 8.7% vs 78.6 ± 5.4%; p = 0.004) and further declined to 7.3% below the term-born group at 80% exercise intensity (69.8 ± 6.4% vs 77.1 ± 6.3%; p = 0.004). Submaximal cardiac output reserve was 56% lower in preterm-born subjects versus term-born control subjects at 40% of peak exercise capacity (729 ± 1,162 ml/min/m2 vs. 1,669 ± 937 ml/min/m2; p = 0.021). LV length and resting peak systolic longitudinal strain predicted EF increase from rest to 60% exercise intensity in the preterm group (r = 0.68, p = 0.009 and r = 0.56, p = 0.031, respectively). <strong>Conclusions</strong> Preterm-born young adults had impaired LV response to physiological stress when subjected to physical exercise, which suggested a reduced myocardial functional reserve that might help explain their increased risk of early heart failure. (Young Adult Cardiovascular Health sTudy [YACHT]; NCT02103231) |
| first_indexed | 2024-03-06T19:22:51Z |
| format | Journal article |
| id | oxford-uuid:1ab04a93-eed8-4f0c-8852-02ff0c9f6aa0 |
| institution | University of Oxford |
| last_indexed | 2024-03-06T19:22:51Z |
| publishDate | 2018 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:1ab04a93-eed8-4f0c-8852-02ff0c9f6aa02022-03-26T10:56:17ZPhysiological stress elicits impaired left ventricular function in preterm-born adultsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1ab04a93-eed8-4f0c-8852-02ff0c9f6aa0Symplectic Elements at OxfordElsevier2018Huckstep, OJWilliamson, WTelles, FBurchert, HBertagnolli, MHerdman, CArnold, LSmillie, RMohamed, ABoardman, HMcCormick, KNeubauer, SLeeson, PLewandowski, AJ<strong>Background</strong> Experimental and clinical studies show that prematurity leads to altered left ventricular (LV) structure and function with preserved resting LV ejection fraction (EF). Large-scale epidemiological data now links prematurity to increased early heart failure risk. <strong>Objectives</strong> Echocardiography imaging was performed at prescribed exercise intensities to determine whether preterm-born adults have impaired LV functional response to physical exercise. <strong>Methods</strong> A total of 101 normotensive young adults born preterm (n = 47; mean gestational age 32.8 ± 3.2 weeks) and term (n = 54) were recruited for detailed cardiovascular phenotyping. Full clinical resting and exercise stress echocardiograms were performed, with apical 4-chamber views collected while exercising at 40%, 60%, and 80% of peak exercise capacity, determined by maximal cardiopulmonary exercise testing. <strong>Results</strong> Preterm-born individuals had greater LV mass (p = 0.015) with lower peak systolic longitudinal strain (p = 0.038) and similar EF to term-born control subjects at rest (p = 0.62). However, by 60% exercise intensity, EF was 6.7% lower in preterm subjects (71.9 ± 8.7% vs 78.6 ± 5.4%; p = 0.004) and further declined to 7.3% below the term-born group at 80% exercise intensity (69.8 ± 6.4% vs 77.1 ± 6.3%; p = 0.004). Submaximal cardiac output reserve was 56% lower in preterm-born subjects versus term-born control subjects at 40% of peak exercise capacity (729 ± 1,162 ml/min/m2 vs. 1,669 ± 937 ml/min/m2; p = 0.021). LV length and resting peak systolic longitudinal strain predicted EF increase from rest to 60% exercise intensity in the preterm group (r = 0.68, p = 0.009 and r = 0.56, p = 0.031, respectively). <strong>Conclusions</strong> Preterm-born young adults had impaired LV response to physiological stress when subjected to physical exercise, which suggested a reduced myocardial functional reserve that might help explain their increased risk of early heart failure. (Young Adult Cardiovascular Health sTudy [YACHT]; NCT02103231) |
| spellingShingle | Huckstep, OJ Williamson, W Telles, F Burchert, H Bertagnolli, M Herdman, C Arnold, L Smillie, R Mohamed, A Boardman, H McCormick, K Neubauer, S Leeson, P Lewandowski, AJ Physiological stress elicits impaired left ventricular function in preterm-born adults |
| title | Physiological stress elicits impaired left ventricular function in preterm-born adults |
| title_full | Physiological stress elicits impaired left ventricular function in preterm-born adults |
| title_fullStr | Physiological stress elicits impaired left ventricular function in preterm-born adults |
| title_full_unstemmed | Physiological stress elicits impaired left ventricular function in preterm-born adults |
| title_short | Physiological stress elicits impaired left ventricular function in preterm-born adults |
| title_sort | physiological stress elicits impaired left ventricular function in preterm born adults |
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