Fetal and infant growth patterns and left and right ventricular measures in childhood assessed by cardiac MRI
Liza Toemen1,2, Romy Gaillard1,2, Arno A Roest3
1The Generation R Study Group, Erasmus University Medical Center, The Netherlands.
Insights
Childhood heart size is linked to growth patterns from fetal development through age 10. Taller, leaner children have larger hearts, while those smaller at birth and heavier in childhood have smaller hearts.
Area of Science:
- Cardiology
- Developmental Biology
- Pediatrics
Background:
- Early life development significantly influences cardiac structure.
- Understanding fetal and childhood growth's impact on heart development is crucial.
Purpose of the Study:
- To investigate the association between longitudinal growth patterns (fetal to childhood) and cardiac dimensions in children.
- To analyze right and left ventricular structures in relation to growth trajectories.
Main Methods:
- A population-based prospective cohort study of 2827 children.
- Growth measurements taken during pregnancy, at birth, and at multiple childhood ages up to 10 years.
- Cardiac magnetic resonance imaging (MRI) used at age 10 to assess ventricular volumes and mass.
Main Results:
- Small size for gestational age at birth correlated with smaller ventricular volumes but a higher left ventricular mass-to-volume ratio.
- Children with larger ventricular volumes and mass at age 10 were larger at birth and grew taller and leaner.
- Conversely, children with smaller ventricular dimensions were smaller at birth and grew shorter and heavier.
Conclusions:
- Both fetal and childhood growth independently impact cardiac dimensions in children.
- Larger body size and leaner physique in childhood are associated with larger heart structures relative to body surface area.
- Growth trajectories significantly shape cardiac development, affecting ventricular size and mass distribution.
Objectives:
Early life is critical for cardiac development. We examined the associations of longitudinal fetal and childhood growth patterns with childhood right and left ventricular structures measured by cardiac magnetic resonance imaging.
Methods:
In a population-based prospective cohort study among 2827 children, we measured growth at 20 and 30 weeks of pregnancy, at birth, 0.5, 1, 2, 6 and 10 years. At 10 years, we measured right ventricular end-diastolic volume, left ventricular end-diastolic volume, left ventricular mass and left ventricular mass-to-volume ratio by cardiac magnetic resonance imaging.
Results:
Small size for gestational age at birth was associated with smaller right and left ventricular end-diastolic volume relative to current body surface area, but with larger left ventricular mass-to-volume ratio (P < 0.05). Children in the upper 25% of right and left ventricular end-diastolic volume and left ventricular mass at age 10 years were larger at birth and became taller and leaner in childhood (P < 0.05). In contrast, children in the lower 25% of right and left ventricular end-diastolic volume and left ventricular mass were smaller at birth and became shorter and heavier in childhood (P < 0.05). Both fetal and childhood growth were independently of each other associated with childhood right and left ventricular end-diastolic volume and left ventricular mass.
Conclusion:
Children who are larger at birth and grow taller and leaner in childhood have larger hearts relative to body surface area. Small size at birth children, who grow shorter and heavier in childhood, have relatively smaller hearts with larger left ventricular mass-to-volume ratio. Both fetal and childhood growth are important for the development of cardiac dimensions.
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