title: Disproportionate cardiac hypertrophy during early postnatal development in infants born preterm.
abstract: BackgroundAdults born very preterm have increased cardiac mass and reduced function. We investigated whether a hypertrophic phenomenon occurs in later preterm infants and when this occurs during early development.MethodsCardiac ultrasound was performed on 392 infants (33% preterm at mean gestation 34±2 weeks). Scans were performed during fetal development in 137, at birth and 3 months of postnatal age in 200, and during both fetal and postnatal development in 55. Cardiac morphology and function was quantified and computational models created to identify geometric changes.ResultsAt birth, preterm offspring had reduced cardiac mass and volume relative to body size with a more globular heart. By 3 months, ventricular shape had normalized but both left and right ventricular mass relative to body size were significantly higher than expected for postmenstrual age (left 57.8±41.9 vs. 27.3±29.4%, P<0.001; right 39.3±38.1 vs. 16.6±40.8, P=0.002). Greater changes were associated with lower gestational age at birth (left P<0.001; right P=0.001).ConclusionPreterm offspring, including those born in late gestation, have a disproportionate increase in ventricular mass from birth up to 3 months of postnatal age. These differences were not present before birth. Early postnatal development may provide a window for interventions relevant to long-term cardiovascular health.
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Christina Y L
authors.initials: CYL
authors.lastname: Aye
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lewandowski
authors.affiliation: Department of Biomedical Engineering, King's College London, London, UK.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lamata
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Ross
authors.initials: R
authors.lastname: Upton
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Esther
authors.initials: E
authors.lastname: Davis
authors.affiliation: Centre for Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK.
authors.forename: Eric O
authors.initials: EO
authors.lastname: Ohuma
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Kenworthy
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Henry
authors.initials: H
authors.lastname: Boardman
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wopperer
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Packham
authors.affiliation: Department of Paediatrics and Neonatology, John Radcliffe Hospital, Oxford, Oxfordshire, UK.
authors.forename: Satish
authors.initials: S
authors.lastname: Adwani
authors.affiliation: Department of Paediatrics and Neonatology, John Radcliffe Hospital, Oxford, Oxfordshire, UK.
authors.forename: Kenny
authors.initials: K
authors.lastname: McCormick
authors.affiliation: Nuffield Department of Obstetrics &Gynaecology, University of Oxford, Oxford, Oxfordshire, UK.
authors.forename: Aris T
authors.initials: AT
authors.lastname: Papageorghiou
authors.affiliation: Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Leeson
mesh_terms: D000886:Anthropometry; D001724:Birth Weight; D001794:Blood Pressure; D049628:Body Size; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003198:Computer Simulation; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006321:Heart / Q000000981:diagnostic imaging / Q000254:growth & development*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000254:growth & development*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D013997:Time Factors; D014463:Ultrasonography; D016278:Ventricular Function, Right