Elevated blood pressure with reduced left ventricular and aortic dimensions in adolescents born extremely preterm

Remi R. Kowalski, Richard Beare, Lex W. Doyle, Joseph J. Smolich, Michael M H Cheung, Victorian Infant Collaborative Study Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To evaluate the long-term cardiovascular effects of extremely preterm birth in a cohort of adolescents followed prospectively, who were largely free from intrauterine growth restriction. Study design: Central blood pressures, aortic and cardiac dimensions, left ventricle (LV) function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were measured in 18-year-old subjects born extremely preterm at <28 weeks' gestation (n = 109) and term-born controls (n = 81). Results Compared with controls, preterm adolescents had higher systolic (124 ± 13 vs 118 ± 10 mm Hg, P =.002) and diastolic (72 ± 8 vs 67 ± 7 mm Hg, P <.001) blood pressures, but lower ascending aortic z-scores (0.13 ± 0.89 vs 0.42 ± 0.78, P =.02), LV diastolic (48.5 ± 4 vs 50.3 ± 4.5 mm, P =.007) and systolic (30.2 ± 3.5 vs 31.9 ± 4.0 mm, P =.003) diameters, and a reduced LV mass (130 ± 34 vs 145 ± 41 g, P =.01) and mass index (75 ± 14 vs 81 ± 16 g/m2, P =.02). However, LV relative wall thickness, LV function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were similar. Within the ex-preterm group, there were no significant relationships between birthweight z-scores and any cardiovascular measures, once the latter were adjusted for current body size. Conclusions Extremely preterm birth had relatively minor cardiovascular effects in late-adolescence, with increased blood pressures, decreased LV, and aortic size, but preserved LV function, macrovascular properties, and microvascular function. In utero growth was not independently related to cardiovascular function within the ex-preterm cohort.

Original languageEnglish
Pages (from-to)75-80
Number of pages6
JournalJournal of Pediatrics
Volume172
DOIs
Publication statusPublished - May 2016
Externally publishedYes

Cite this

Kowalski, R. R., Beare, R., Doyle, L. W., Smolich, J. J., Cheung, M. M. H., & Victorian Infant Collaborative Study Group (2016). Elevated blood pressure with reduced left ventricular and aortic dimensions in adolescents born extremely preterm. Journal of Pediatrics, 172, 75-80. https://doi.org/10.1016/j.jpeds.2016.01.020
Kowalski, Remi R. ; Beare, Richard ; Doyle, Lex W. ; Smolich, Joseph J. ; Cheung, Michael M H ; Victorian Infant Collaborative Study Group. / Elevated blood pressure with reduced left ventricular and aortic dimensions in adolescents born extremely preterm. In: Journal of Pediatrics. 2016 ; Vol. 172. pp. 75-80.
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abstract = "Objective: To evaluate the long-term cardiovascular effects of extremely preterm birth in a cohort of adolescents followed prospectively, who were largely free from intrauterine growth restriction. Study design: Central blood pressures, aortic and cardiac dimensions, left ventricle (LV) function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were measured in 18-year-old subjects born extremely preterm at <28 weeks' gestation (n = 109) and term-born controls (n = 81). Results Compared with controls, preterm adolescents had higher systolic (124 ± 13 vs 118 ± 10 mm Hg, P =.002) and diastolic (72 ± 8 vs 67 ± 7 mm Hg, P <.001) blood pressures, but lower ascending aortic z-scores (0.13 ± 0.89 vs 0.42 ± 0.78, P =.02), LV diastolic (48.5 ± 4 vs 50.3 ± 4.5 mm, P =.007) and systolic (30.2 ± 3.5 vs 31.9 ± 4.0 mm, P =.003) diameters, and a reduced LV mass (130 ± 34 vs 145 ± 41 g, P =.01) and mass index (75 ± 14 vs 81 ± 16 g/m2, P =.02). However, LV relative wall thickness, LV function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were similar. Within the ex-preterm group, there were no significant relationships between birthweight z-scores and any cardiovascular measures, once the latter were adjusted for current body size. Conclusions Extremely preterm birth had relatively minor cardiovascular effects in late-adolescence, with increased blood pressures, decreased LV, and aortic size, but preserved LV function, macrovascular properties, and microvascular function. In utero growth was not independently related to cardiovascular function within the ex-preterm cohort.",
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Kowalski, RR, Beare, R, Doyle, LW, Smolich, JJ, Cheung, MMH & Victorian Infant Collaborative Study Group 2016, 'Elevated blood pressure with reduced left ventricular and aortic dimensions in adolescents born extremely preterm' Journal of Pediatrics, vol. 172, pp. 75-80. https://doi.org/10.1016/j.jpeds.2016.01.020

Elevated blood pressure with reduced left ventricular and aortic dimensions in adolescents born extremely preterm. / Kowalski, Remi R.; Beare, Richard; Doyle, Lex W.; Smolich, Joseph J.; Cheung, Michael M H; Victorian Infant Collaborative Study Group.

In: Journal of Pediatrics, Vol. 172, 05.2016, p. 75-80.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Kowalski, Remi R.

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AU - Doyle, Lex W.

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AU - Cheung, Michael M H

AU - Victorian Infant Collaborative Study Group

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N2 - Objective: To evaluate the long-term cardiovascular effects of extremely preterm birth in a cohort of adolescents followed prospectively, who were largely free from intrauterine growth restriction. Study design: Central blood pressures, aortic and cardiac dimensions, left ventricle (LV) function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were measured in 18-year-old subjects born extremely preterm at <28 weeks' gestation (n = 109) and term-born controls (n = 81). Results Compared with controls, preterm adolescents had higher systolic (124 ± 13 vs 118 ± 10 mm Hg, P =.002) and diastolic (72 ± 8 vs 67 ± 7 mm Hg, P <.001) blood pressures, but lower ascending aortic z-scores (0.13 ± 0.89 vs 0.42 ± 0.78, P =.02), LV diastolic (48.5 ± 4 vs 50.3 ± 4.5 mm, P =.007) and systolic (30.2 ± 3.5 vs 31.9 ± 4.0 mm, P =.003) diameters, and a reduced LV mass (130 ± 34 vs 145 ± 41 g, P =.01) and mass index (75 ± 14 vs 81 ± 16 g/m2, P =.02). However, LV relative wall thickness, LV function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were similar. Within the ex-preterm group, there were no significant relationships between birthweight z-scores and any cardiovascular measures, once the latter were adjusted for current body size. Conclusions Extremely preterm birth had relatively minor cardiovascular effects in late-adolescence, with increased blood pressures, decreased LV, and aortic size, but preserved LV function, macrovascular properties, and microvascular function. In utero growth was not independently related to cardiovascular function within the ex-preterm cohort.

AB - Objective: To evaluate the long-term cardiovascular effects of extremely preterm birth in a cohort of adolescents followed prospectively, who were largely free from intrauterine growth restriction. Study design: Central blood pressures, aortic and cardiac dimensions, left ventricle (LV) function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were measured in 18-year-old subjects born extremely preterm at <28 weeks' gestation (n = 109) and term-born controls (n = 81). Results Compared with controls, preterm adolescents had higher systolic (124 ± 13 vs 118 ± 10 mm Hg, P =.002) and diastolic (72 ± 8 vs 67 ± 7 mm Hg, P <.001) blood pressures, but lower ascending aortic z-scores (0.13 ± 0.89 vs 0.42 ± 0.78, P =.02), LV diastolic (48.5 ± 4 vs 50.3 ± 4.5 mm, P =.007) and systolic (30.2 ± 3.5 vs 31.9 ± 4.0 mm, P =.003) diameters, and a reduced LV mass (130 ± 34 vs 145 ± 41 g, P =.01) and mass index (75 ± 14 vs 81 ± 16 g/m2, P =.02). However, LV relative wall thickness, LV function, pulse wave velocity, augmentation index, and microvascular reactive hyperemia were similar. Within the ex-preterm group, there were no significant relationships between birthweight z-scores and any cardiovascular measures, once the latter were adjusted for current body size. Conclusions Extremely preterm birth had relatively minor cardiovascular effects in late-adolescence, with increased blood pressures, decreased LV, and aortic size, but preserved LV function, macrovascular properties, and microvascular function. In utero growth was not independently related to cardiovascular function within the ex-preterm cohort.

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