Changes in the Preterm Heart From Birth to Young Adulthood: A Meta-analysis

Area of Science:

• Cardiology
• Developmental Biology
• Pediatrics

Background:

• Preterm birth is a significant risk factor for heart failure in children and young adults.
• Understanding the long-term cardiac effects of preterm birth is crucial for early intervention and management.

Purpose of the Study:

• To quantify the effect size of preterm birth on cardiac remodeling from birth through young adulthood.
• To identify specific cardiac structural and functional changes associated with preterm birth over time.

Main Methods:

• Systematic review and meta-analysis of 32 observational studies comparing preterm and term-born individuals.
• Inclusion criteria: studies comparing cardiac phenotype in preterm (<37 weeks gestation) and age-matched term controls.
• Data extraction and analysis using random-effects models to calculate weighted mean differences and confidence intervals.

Main Results:

• Preterm neonates exhibited lower left ventricular (LV) and right ventricular (RV) systolic function, including LV ejection fraction.
• Persistent differences observed: lower LV stroke volume index in young adulthood, reduced LV peak early diastolic tissue velocity, and impaired diastolic function in preterm individuals.
• RV longitudinal strain was consistently lower in preterm individuals, proportional to prematurity. Preterm individuals showed smaller LV dimensions and increased LV mass over time.

Conclusions:

• Preterm-born individuals experience significant morphologic and functional cardiac impairments throughout development.
• These cardiac alterations may predispose the preterm heart to secondary insults, contributing to an elevated risk of early heart failure.