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Proportionality at birth and left ventricular hypertrophy in healthy adolescents
Alexandra A Sawyer1, Norman K Pollock2, Bernard Gutin3
1Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Insights
Birth proportionality, not just birth weight, is linked to adolescent heart structure. This suggests early growth patterns influence cardiac remodeling, impacting cardiovascular health long-term.
Area of Science:
- Cardiology
- Developmental Biology
- Pediatrics
Background:
- Perinatal growth significantly impacts cardiac development.
- Low birth weight is a known risk factor for cardiovascular events and mortality.
- Fetal growth restriction can lead to permanent loss of cardiomyocytes and compensatory hypertrophy.
Purpose of the Study:
- To investigate the association between birth weight and proportionality indices (BMI, Ponderal Index) at birth with left ventricular (LV) structure and function in adolescents.
- To determine if birth proportionality offers insights into cardiac remodeling beyond birth weight alone.
Main Methods:
- Echocardiography was used to assess LV structure and function parameters in 379 healthy adolescents (aged 14-18 years).
- Parameters included intraventricular septal thickness, LV internal dimensions, posterior wall thickness, relative wall thickness, fractional shortening, and ejection fraction.
- Linear regression analyses adjusted for age, sex, race, Tanner stage, socioeconomic status, and physical activity were performed.
Main Results:
- Birth weight showed a positive association with LV internal dimension in diastole.
- Birth Body Mass Index (BMI) was associated with LV mass index.
- Birth Ponderal Index (PI) was associated with intraventricular septal thickness, LV posterior wall thickness, and LV mass index.
- A U-shaped trend was observed for LV mass index across Ponderal Index tertiles.
Conclusions:
- Proportionality at birth, assessed by indices like BMI and PI, is associated with adolescent cardiac remodeling.
- These findings suggest that birth proportionality may identify risks for cardiac remodeling independent of birth weight alone.
- Early growth patterns and body proportions at birth have lasting implications for cardiovascular health.
Background:
Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy.
Aims:
To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length2 and Ponderal index (PI); weight/length3) at birth on one hand, with left ventricular (LV) structure and function during adolescence.
Subjects:
379 healthy adolescents aged 14-18 years in Augusta, Georgia.
Outcome Measures:
LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography.
Results:
When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (Pquadratic = 0.04) was identified.
Conclusions:
Our adolescent data suggest that proportionality at birth may identify associations between perinatal growth and cardiac remodeling independent of birthweight alone.
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