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Published on: May 24, 2016
Preterm Birth Is Associated with Altered Myocardial Function in Infancy
Ulf Schubert1, Matthias Müller2, Hashim Abdul-Khaliq2
1Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Insights
Very preterm infants show altered left ventricular function by 6 months after birth. Further research is needed to understand the long-term cardiovascular health implications for these children.
Area of Science:
- Neonatal cardiology
- Pediatric cardiovascular research
- Fetal development and cardiac function
Background:
- Preterm birth is linked to myocardial remodeling and accelerated cardiovascular aging.
- The precise mechanisms driving these long-term cardiac changes remain unclear.
- Echocardiography is a key tool for assessing infant myocardial function.
Purpose of the Study:
- To sequentially analyze myocardial function in very preterm infants.
- To compare cardiac performance in very preterm infants versus term-born infants.
- To identify early indicators of potential cardiovascular complications.
Main Methods:
- Speckle-tracking echocardiography was used to evaluate myocardial deformation and velocity.
- Cardiac function was assessed in 25 very preterm infants (26-30 weeks gestation) at birth, 3, and 6 months corrected age.
- Results were compared to 30 term-born infants assessed at birth and 3 months.
Main Results:
- Left ventricular longitudinal strain and diastolic myocardial velocities were significantly lower in very preterm infants at 6 months corrected age.
- No significant differences were observed in right ventricular or interventricular septal measurements between groups.
- Conventional echocardiographic variables did not differ significantly at any time point.
Conclusions:
- Very preterm infants exhibit altered left ventricular myocardial function 6 months post-birth.
- Longitudinal follow-up is crucial to determine the cardiovascular health implications for survivors of very preterm birth.
- Early detection of myocardial changes may inform future preventative strategies.
Background:
Preterm birth has been associated with myocardial remodeling and accelerated cardiovascular ageing in later life, but the underlying mechanisms are unknown. The investigators used echocardiography to undertake a sequential analysis of myocardial function in preterm infants.
Methods:
This study evaluated the cardiac performance of 25 very preterm infants (born at a gestational age of 26-30 weeks), at birth, 3 months (term-equivalent age), and 6 months later (3 months of corrected age). Speckle-tracking echocardiography was used to determine myocardial function, assessing the magnitude of myocardial deformation as longitudinal strain, deformation rate (strain rate), and velocity in both ventricles during systole and diastole. The results were compared with those in 30 infants born at term investigated at birth and at 3 months of age.
Results:
At term-equivalent age, the speckle-tracking estimates were similar in both groups. Three months later, very preterm infants exhibited significantly lower left ventricular mean free wall longitudinal strain (-20.0% vs -22.0%, P = .010) and lower left ventricular early diastolic (median, -7.37 vs -10.9 cm/sec, P = .003) and late diastolic (median, -5.11 vs -6.95 cm/sec, P = .009) myocardial velocities than infants born at term. There were no statistically significant group differences in right ventricular or interventricular septal measurements. Conventional echocardiographic variables did not differ significantly between the two groups at any age.
Conclusions:
Very preterm infants develop altered left ventricular myocardial function 6 months after birth. Follow-up examinations are needed to determine the implications for cardiovascular health in the growing number of children surviving very preterm birth.
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