Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk

被引:75
作者
Lewandowski, Adam J. [1 ]
Levy, Philip T. [2 ]
Bates, Melissa L. [3 ,4 ]
McNamara, Patrick J. [4 ,5 ]
Nuyt, Anne Monique [6 ]
Goss, Kara N. [7 ,8 ]
机构
[1] Univ Oxford, Radcliffe Dept Med, Div Cardiovasc Med, Oxford Cardiovasc Clin Res Facil, Oxford, England
[2] Harvard Univ, Harvard Med Sch, Boston Childrens Hosp, Dept Pediat, Cambridge, MA 02138 USA
[3] Univ Iowa, Dept Hlth & Human Physiol, Iowa City, IA 52242 USA
[4] Univ Iowa, Div Neonatol, Iowa City, IA 52242 USA
[5] Univ Iowa, Div Cardiol, Iowa City, IA 52242 USA
[6] Univ Montreal, Fac Med, CHU St Justine, Dept Pediat,Div Neonatol, Montreal, PQ, Canada
[7] Univ Wisconsin Madison, Sch Med & Publ Hlth, Dept Pediat, Madison, WI 53706 USA
[8] Univ Wisconsin Madison, Sch Med & Publ Hlth, Dept Med, Madison, WI 53706 USA
基金
加拿大健康研究院;
关键词
cardiovascular diseases; hypertension; pulmonary; premature birth; vascular stiffness; LOW-BIRTH-WEIGHT; PULMONARY ARTERIAL-HYPERTENSION; ELEVATED BLOOD-PRESSURE; INTIMA-MEDIA THICKNESS; YOUNG-ADULTS; BORN PRETERM; GESTATIONAL-AGE; OXYGEN EXPOSURE; CHILDREN; DYSFUNCTION;
D O I
10.1161/HYPERTENSIONAHA.120.15574
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
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.
引用
收藏
页码:1028 / 1037
页数:10
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