TY - JOUR
T1 - Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
AU - Lewandowski, Adam J.
AU - Levy, Philip T.
AU - Bates, Melissa L.
AU - McNamara, Patrick J.
AU - Nuyt, Anne Monique
AU - Goss, Kara N.
N1 - Publisher Copyright:
© 2020 The Authors.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Preterm birth accounts for over 15 million global births per year. Perinatal interventions introduced since the early 1980s, such as antenatal glucocorticoids, surfactant, and invasive ventilation strategies, have dramatically improved survival of even the smallest, most vulnerable neonates. As a result, a new generation of preterm-born individuals has now reached early adulthood, and they are at increased risk of cardiovascular diseases. To better understand the sequelae of preterm birth, cardiovascular follow-up studies in adolescents and young adults born preterm have focused on characterizing changes in cardiac, vascular, and pulmonary structure and function. Being born preterm associates with a reduced cardiac reserve and smaller left and right ventricular volumes, as well as decreased vascularity, increased vascular stiffness, and higher pressure of both the pulmonary and systemic vasculature. The purpose of this review is to present major epidemiological evidence linking preterm birth with cardiovascular disease; to discuss findings from clinical studies showing a long-term impact of preterm birth on cardiac remodeling, as well as the systemic and pulmonary vascular systems; to discuss differences across gestational ages; and to consider possible driving mechanisms and therapeutic approaches for reducing cardiovascular burden in individuals born preterm.
AB - Preterm birth accounts for over 15 million global births per year. Perinatal interventions introduced since the early 1980s, such as antenatal glucocorticoids, surfactant, and invasive ventilation strategies, have dramatically improved survival of even the smallest, most vulnerable neonates. As a result, a new generation of preterm-born individuals has now reached early adulthood, and they are at increased risk of cardiovascular diseases. To better understand the sequelae of preterm birth, cardiovascular follow-up studies in adolescents and young adults born preterm have focused on characterizing changes in cardiac, vascular, and pulmonary structure and function. Being born preterm associates with a reduced cardiac reserve and smaller left and right ventricular volumes, as well as decreased vascularity, increased vascular stiffness, and higher pressure of both the pulmonary and systemic vasculature. The purpose of this review is to present major epidemiological evidence linking preterm birth with cardiovascular disease; to discuss findings from clinical studies showing a long-term impact of preterm birth on cardiac remodeling, as well as the systemic and pulmonary vascular systems; to discuss differences across gestational ages; and to consider possible driving mechanisms and therapeutic approaches for reducing cardiovascular burden in individuals born preterm.
KW - cardiovascular diseases
KW - hypertension
KW - hypertension, pulmonary
KW - premature birth
KW - vascular stiffness
UR - http://www.scopus.com/inward/record.url?scp=85090869797&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090869797&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.120.15574
DO - 10.1161/HYPERTENSIONAHA.120.15574
M3 - Review article
C2 - 32816574
AN - SCOPUS:85090869797
SN - 0194-911X
VL - 76
SP - 1028
EP - 1037
JO - Hypertension
JF - Hypertension
IS - 4
ER -