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Association of Bronchopulmonary Dysplasia and Right Ventricular Systolic Function in Young Adults Born Preterm
Daniela Ravizzoni Dartora1, Adrien Flahault1, Thuy Mai Luu2
1Sainte-Justine University Hospital Research Center Sainte-Justine University Hospital, Faculty of Medicine, University of Montreal, Montreal, QB, Canada.
Insights
Adults born preterm exhibit altered right ventricular systolic function, particularly those with bronchopulmonary dysplasia (BPD). These cardiac changes persist into early adulthood, highlighting long-term health risks.
Area of Science:
- Cardiology
- Neonatology
- Pulmonology
Background:
- Adults born preterm face increased risks for cardiopulmonary disease and premature death.
- Preterm birth is linked to right ventricular (RV) abnormalities, but the effect of bronchopulmonary dysplasia (BPD) is unclear.
Purpose of the Study:
- To investigate if preterm birth and BPD are associated with RV structure and function alterations in early adulthood.
Main Methods:
- Echocardiographic and spirometry data were collected from adults born preterm (with and without BPD) and term-born controls.
- RV structure and systolic/diastolic function were assessed using echocardiography.
- Respiratory function was evaluated via spirometry.
Main Results:
- Preterm-born adults showed impaired RV systolic function (lower TAPSE, RV s', VTI), especially those with BPD.
- A higher proportion of preterm-born adults with BPD had RV systolic dysfunction (TAPSE < 16 mm) compared to preterm without BPD and term-born controls.
- No significant differences were observed in RV diastolic function or pulmonary artery pressure estimates.
Conclusions:
- Preterm birth is associated with impaired adult RV systolic function, with BPD exacerbating these changes.
- Respiratory function alterations in preterm-born individuals did not correlate with RV systolic function deficits.
Background:
Adults born preterm are at a higher risk of cardiopulmonary disease and premature death. Preterm birth is associated with abnormalities in right ventricular (RV) structure and function, but the impact of bronchopulmonary dysplasia (BPD), a common complication of extremely preterm birth, on these parameters remains unknown.
Research Question:
Are preterm birth and BPD associated with alterations in RV structure and function in early adulthood?
Study Design And Methods:
Echocardiographic and spirometry data were obtained from the Health of Adults Born Preterm Investigation (HAPI). RV structure and performance were evaluated by using echocardiography, and respiratory function was assessed by using spirometry.
Results:
The study comprised 86 young adults born preterm before 30 weeks of gestation, including 28 with moderate to severe BPD, and 85 adults of the same age born full term. Individuals were assessed at a mean age of 23 years. RV systolic function was altered in the preterm group, with lower tricuspid annular plane systolic excursion and lower RV s' and RV outflow tract velocity time integral values, especially in those born preterm with BPD. Nine (36%) participants born preterm with BPD, six (13%) participants born preterm without BPD, and six (8%) participants born full term had a tricuspid annular plane systolic excursion value < 16 mm, a marker of RV systolic dysfunction (P value for the comparison between preterm no BPD and BPD, .032). No difference was found in RV diastolic function or estimates of pulmonary artery pressure between groups. Although respiratory function was altered in those born preterm, and more so in the case of BPD, no association was observed between spirometry indices of respiratory function and RV systolic function.
Interpretation:
Preterm birth is associated in adulthood with alterations in RV systolic function, which are more pronounced in the case of BPD.
Clinical Trial Registration:
ClinicalTrials.gov; No.: NCT03261609; URL: www.clinicaltrials.gov.
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