Physiological Stress Elicits Impaired Left Ventricular Function in Preterm-Born Adults

Area of Science:

• Cardiology
• Physiology
• Neonatology

Background:

• Prematurity is linked to altered left ventricular (LV) structure and function.
• Epidemiological data indicates prematurity increases early heart failure risk.

Purpose of the Study:

• To investigate if preterm-born adults exhibit impaired LV functional response to physical exercise.
• To assess cardiovascular adaptations to exercise in young adults born preterm.

Main Methods:

• 101 young adults (47 preterm, 54 term-born) underwent cardiovascular phenotyping.
• Resting and exercise stress echocardiograms were performed at 40%, 60%, and 80% of peak exercise capacity.
• Maximal cardiopulmonary exercise testing determined peak exercise capacity.

Main Results:

• Preterm individuals had greater LV mass and lower resting peak systolic longitudinal strain.
• At 60% exercise intensity, ejection fraction was significantly lower in preterm subjects (71.9% vs 78.6%).
• Submaximal cardiac output reserve was 56% lower in preterm subjects at 40% peak exercise capacity.

Conclusions:

• Preterm-born young adults demonstrate impaired LV response to physiological stress during exercise.
• This suggests a reduced myocardial functional reserve in preterm survivors.
• The findings may elucidate the increased risk of early heart failure observed in this population.