The Preterm Heart-Brain Axis in Young Adulthood: The Impact of Birth History and Modifiable Risk Factors

Area of Science:

• Cardiology
• Neurology
• Developmental Pediatrics

Background:

• Individuals born preterm face increased risks for cardiac and brain abnormalities.
• The long-term impact of cardiovascular changes on brain structure in preterm-born individuals is not fully understood.

Purpose of the Study:

• To investigate if cardiovascular physiology affects brain structure in young adulthood among those born preterm.
• To determine if cardiac changes in preterm-born adults correlate with modifiable biomarkers.

Main Methods:

• Cardiac MRI and brain MRI were performed on 48 preterm-born individuals and term-born controls.
• Participants were assessed in young adulthood (mean age ~25-33 years).
• Cardiac parameters (stroke volume, end-diastolic volume, ejection fraction) and brain structures were analyzed.

Main Results:

• Significant differences in cardiac ventricular volumes and function were observed between preterm and term-born groups.
• Cardiac abnormalities in preterm-born individuals were associated with subcortical brain volumes and corpus callosum white matter integrity.
• Specific associations between left ventricular metrics and thalamus/putamen volumes persisted after adjusting for early-life factors.

Conclusions:

• Cardiovascular abnormalities in young adults born preterm are linked to potentially adverse brain health outcomes.
• These findings underscore the importance of cardiovascular health for long-term brain health in preterm survivors.
• While modifiable biomarkers showed no significant associations, cardiovascular interventions may benefit brain health in this population.