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Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
Journal article   Open access   Peer reviewed

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

Adam J. Lewandowski, Philip T. Levy, Melissa L. Bates, Patrick J. McNamara, Anne Monique Nuyt and Kara N. Goss
Hypertension (Dallas, Tex. 1979), Vol.76(4), pp.1028-1037
10/01/2020
DOI: 10.1161/HYPERTENSIONAHA.120.15574
PMCID: PMC7480939
PMID: 32816574
url
https://doi.org/10.1161/HYPERTENSIONAHA.120.15574View
Published (Version of record) Open Access

Abstract

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.
Cardiovascular System & Cardiology Life Sciences & Biomedicine Peripheral Vascular Disease Science & Technology

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