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Published on: June 29, 2013
Impaired central arterial elasticity in young adults born with intrauterine growth restriction
Pier Paolo Bassareo1, Luca Saba2, Melania Puddu3
1Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy - piercard@inwind.it.
Insights
Individuals born preterm exhibit reduced aortic distensibility and increased aortic stiffness, indicating accelerated vascular aging. This early arterial dysfunction, linked to birth weight and gestational age, may increase future cardiovascular risks.
Area of Science:
- Cardiovascular research
- Vascular biology
- Neonatal health
Background:
- Prematurity and intrauterine growth restriction are known risk factors for adverse cardiovascular events.
- Peripheral arterial dysfunction has been observed in preterm individuals, but central arterial properties remain understudied.
Purpose of the Study:
- To investigate central (aortic) arterial distensibility in young adults born preterm.
- To compare aortic elasticity between ex-preterm individuals and those born at term.
Main Methods:
- Sixty young adults (30 ex-preterm, 30 term-born controls) were assessed.
- Non-invasive measurement of aortic root distensibility and aortic stiffness index using echocardiography and blood pressure.
- Correlation analysis with birth weight and gestational age.
Main Results:
- Ex-preterm individuals showed significantly lower aortic distensibility and higher aortic stiffness index compared to controls.
- These arterial changes correlated significantly with lower birth weight and shorter gestational age.
- Intrauterine growth restriction, indicated by birth weight, was the primary determinant of impaired central arterial elasticity, independent of body mass index.
Conclusions:
- Former preterm subjects demonstrate evidence of premature vascular aging, with impaired aortic elasticity.
- This finding suggests a potentially higher risk for future cardiovascular morbidity in this population.
- Early identification and management of vascular changes in preterm individuals may be crucial.
Background:
Intrauterine growth retardation and prematurity at birth constitute risk factors for future cardiovascular adverse events. Some previous reports have highlighted that subjects born preterm may develop peripheral arterial dysfunction. However, central (aortic) arterial distensibility has not yet been fully investigated in these subjects.
Methods:
Sixty subjects were enrolled: thirty were high grade ex-preterm subjects (10 males [M] and 20 females [F], aged 17-28, mean 20.1±2.5 years). They were compared with 30 healthy, age-matched subjects born at term (C, 10 M and 20 F). Central aortic elasticity was assessed non-invasively by calculating two indexes derived from echocardiographic and blood pressure measures: aortic root distensibility and aortic stiffness index.
Results:
Aortic distensibility was significantly lower (P<0.0001), and aortic stiffness index was significantly higher (P<0.0001) in former preterm individuals than in controls. The above stated indexes were correlated with birth weight (r=0.78, P<0.0001 and r=-0.41, P=0.02, respectively), as well as with gestational age (r=0.54, P=0.002 and r=-0.37, P=0.04, respectively). When excluding the influence of body mass index, intrauterine growth restriction - expressed as birth weight - remains the only determinant of impaired central arterial elasticity.
Conclusions:
Since aortic distensibility usually impairs in time, former preterm subjects appear to have a "vascular age" older than their healthy born at term peers. This finding may have important implications for cardiovascular morbidity in later life.
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