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Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults: A Randomized Clinical
Winok Lapidaire1, Afifah Mohamed2, Wilby Williamson3
1Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
Insights
Aerobic exercise improved heart function in adults born preterm, but did not alter cardiac structure. This finding highlights the benefits of exercise for preterm-born individuals with elevated blood pressure.
Area of Science:
- Cardiology
- Exercise Physiology
- Neonatology
Background:
- Individuals born preterm (<37 weeks' gestation) may have an adverse cardiac phenotype that worsens with elevated blood pressure.
- Understanding the long-term cardiac effects of preterm birth and the impact of interventions is crucial for cardiovascular health.
Purpose of the Study:
- To investigate whether preterm-born and term-born adults show similar cardiac structural and functional remodeling after a 16-week aerobic exercise intervention.
- To compare the effects of aerobic exercise on cardiac parameters in preterm-born versus term-born adults with elevated blood pressure.
Main Methods:
- A randomized controlled trial involving 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension.
- Participants were randomized to a 16-week aerobic exercise intervention or a control group.
- Cardiovascular magnetic resonance imaging (CMR) was used to assess left and right ventricular (LV and RV) structure and function before and after the intervention.
Main Results:
- In term-born participants, aerobic exercise led to a decrease in LV mass to end-diastolic volume ratio and an increase in RV stroke volume index.
- Preterm-born participants in the exercise group showed improvements in LV circumferential strain and RV global longitudinal strain, but no significant changes in cardiac structure.
- No significant cardiac structural changes were observed in preterm-born participants, and no significant myocardial deformation effects were seen in term-born participants.
Conclusions:
- Aerobic exercise training improves myocardial function in preterm-born adults but does not significantly alter cardiac structure.
- These findings suggest that while exercise benefits cardiac function, structural adaptations may differ between preterm-born and term-born individuals.
Background:
People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation.
Objectives:
The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention.
Methods:
We conducted a randomized controlled trial in 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension. Participants were randomized 1:1 to a 16-week aerobic exercise intervention or to a control group. In a prespecified cardiovascular magnetic resonance imaging (CMR) substudy, CMR was performed at 3.0-Tesla to assess left and right ventricular (LV and RV) structure and function before and after intervention.
Results:
A total of 100 participants completed CMR scans at baseline and after the 16-week intervention, with n = 47 in the exercise intervention group (n = 26 term-born; n = 21 preterm-born) and n = 53 controls (n = 32 term-born; n = 21 preterm-born). In term-born participants, LV mass to end-diastolic volume ratio decreased (-3.43; 95% CI: -6.29 to -0.56; interaction P = 0.027) and RV stroke volume index increased (5.53 mL/m2; 95% CI: 2.60, 8.47; interaction P = 0.076) for those in the exercise intervention group vs controls. No significant effects were observed for cardiac structural indices in preterm-born participants. In preterm-born participants, LV basal- and mid-ventricular circumferential strain increased (-1.33; 95% CI: -2.07 to -0.60; interaction P = 0.057 and -1.54; 95% CI: -2.46 to -0.63; interaction P = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: -3.12 to -0.87; interaction P = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants.
Conclusions:
Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.
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