Reduced Right Ventricular Size and Function in Adolescents and Adults Born Preterm

Area of Science:

• Cardiology
• Neonatology
• Pediatric Health

Background:

• Adults born premature often exhibit smaller cardiac chambers and may develop right ventricular (RV) dysfunction.
• Risk factors contributing to RV dysfunction in adulthood among preterm-born individuals are not fully understood.

Purpose of the Study:

• To investigate right-sided cardiac structure and function in adolescents and adults born preterm.
• To identify associations between prematurity and cardiac abnormalities.

Main Methods:

• Recruited preterm (≤32 weeks gestation or <1500 g) and healthy term-born participants aged 12-40 years.
• Conducted anthropometric measurements, cardiopulmonary examination, and echocardiography.
• Utilized multivariable linear regression to analyze the effect of prematurity on right atrial and RV structure/function, adjusting for covariates.

Main Results:

• Preterm participants (n=107) showed smaller right atrial volume and RV area compared to term-born controls (n=48).
• Reduced tricuspid annular plane systolic excursion, RV s', and RV e' were observed in preterm individuals.
• A dose-response relationship was found between gestational age and these functional deficits, even without overt pulmonary hypertension.

Conclusions:

• Adolescents and adults born preterm have smaller right-sided heart chambers and impaired RV function.
• Reduced RV function in preterm individuals is associated with gestational age and occurs independently of pulmonary hypertension.
• Preterm birth appears to impose an independent insult on the developing right ventricle, with potential lifelong cardiovascular consequences.