Early Pulmonary Vascular Disease in Young Adults Born Preterm
| Autor: | Kristin Haraldsdottir, Kara N. Goss, Andrew M. Watson, Naomi C. Chesler, Laura H. Tetri, Mari Palta, Gregory P. Barton, Ashley Mulchrone, Therese J. Battiola, Taylor S. Levin, Marlowe W. Eldridge, Luke Lamers, Arij G. Beshish, David F. Pegelow |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics Respiratory System Reproductive health and childbirth 030204 cardiovascular system & hematology Cardiovascular Low Birth Weight and Health of the Newborn Critical Care and Intensive Care Medicine Medical and Health Sciences 0302 clinical medicine pulmonary hypertension Infant Mortality Prospective Studies Young adult Lung Pediatric exercise Age Factors Pulmonary Heart Disease Premature birth Hypertension Respiratory Female Infant Premature Pulmonary and Respiratory Medicine Adult medicine.medical_specialty Hypertension Pulmonary 03 medical and health sciences Preterm bronchopulmonary dysplasia medicine Humans Vascular Diseases Premature business.industry Vascular disease Prevention prematurity Infant Newborn Editorials Infant Perinatal Period - Conditions Originating in Perinatal Period Newborn medicine.disease Pulmonary hypertension right ventricular function Good Health and Well Being 030228 respiratory system Bronchopulmonary dysplasia business |
| Zdroj: | American journal of respiratory and critical care medicine, vol 198, iss 12 |
| ISSN: | 1535-4970 |
| Popis: | Rationale: Premature birth affects 10% of live births in the United States and is associated with alveolar simplification and altered pulmonary microvascular development. However, little is known about the long-term impact prematurity has on the pulmonary vasculature.Objectives: Determine the long-term effects of prematurity on right ventricular and pulmonary vascular hemodynamics.Methods: Preterm subjects (n = 11) were recruited from the Newborn Lung Project, a prospectively followed cohort at the University of Wisconsin-Madison, born preterm with very low birth weight (≤1,500 g; average gestational age, 28 wk) between 1988 and 1991. Control subjects (n = 10) from the same birth years were recruited from the general population. All subjects had no known adult cardiopulmonary disease. Right heart catheterization was performed to assess right ventricular and pulmonary vascular hemodynamics at rest and during hypoxic and exercise stress.Measurements and Main Results: Preterm subjects had higher mean pulmonary arterial pressures (mPAPs), with 27% (3 of 11) meeting criteria for borderline pulmonary hypertension (mPAP, 19-24 mm Hg) and 18% (2 of 11) meeting criteria for overt pulmonary hypertension (mPAP ≥ 25 mm Hg). Pulmonary vascular resistance and elastance were higher at rest and during exercise, suggesting a stiffer vascular bed. Preterm subjects were significantly less able to augment cardiac index or right ventricular stroke work during exercise. Among neonatal characteristics, total ventilatory support days was the strongest predictor of adult pulmonary pressure.Conclusions: Young adults born preterm demonstrate early pulmonary vascular disease, characterized by elevated pulmonary pressures, a stiffer pulmonary vascular bed, and right ventricular dysfunction, consistent with an increased risk of developing pulmonary hypertension. |
| Databáze: | OpenAIRE |
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