Aortic Elastic Properties in Preschool Children Born Preterm

Abstract

Objective-Preterm birth predisposes children to the development of cardiovascular diseases in adulthood. The aim of this study was to characterize elastic properties of the aorta at preschool age and test the hypothesis that prematurity is associated with decreased aortic distensibility and increased stiffness, both of which are predictors of increased cardiovascular risk. Approach and Results-In an observational study of 76 five-to seven-year-old children born at a gestational age <32 weeks and 79 term-born controls, elastic parameters of the ascending and descending abdominal aorta were determined noninvasively by means of M mode echocardiographic tracings and calculated using computerized wall contour analysis. Compared with children born at term, the preterm group showed significantly reduced distensibility and increased stiffness of the descending abdominal aorta. These results remained significant under multivariable adjustment for birth weight z score, maternal smoking in pregnancy, maternal education, family history of cardiovascular disease, breastfeeding, childhood nutrition, and current body mass index z score (multivariable odds ratios and 95% confidence intervals 5.1, 1.7-15.9; P=0.005 and 2.8, 1.0-7.9; P=0.046, respectively). Further adjustment for intravenous lipid therapy attenuated the strength of association. Elastic properties of the ascending aorta did not differ between the 2 study groups. Conclusions-Children

Former very preterm infants show alterations in plasma amino acid profiles at a preschool age

“…A growing body of evidence suggests an association of BCAA concentrations with unfavorable cardiometabolic phenotypes in both adult and pediatric cohorts (7,12,(40)(41)(42). Interestingly, even though we have recently shown that former VPI have an adverse classical and echocardiographic cardiovascular risk profile (4,5), BCAA concentrations were lower in former VPI than in term-born controls in this study. However, BCAA plasma concentrations are known to be closely related to visceral fat accumulation (8,9), which seems to be of minor relevance in our study population, as former VPI had significantly lower BMI and BMI z-scores at study visit than term-born controls.…”

“…A growing body of evidence suggests that prematurity is associated with an unfavorable cardiovascular risk profile in adolescent and adult life (3). Our research group has recently shown that major modifiable markers of an increased cardiovascular risk (elevated blood pressure, raised blood glucose levels and lipid alterations) are present in former very preterm infants (VPI) even at a preschool age and that former VPI display decreased elastic properties of the descending abdominal aorta (4,5). In addition to traditional risk factors, metabolic profiling including plasma amino acid analyses and amino acid-derived scoring systems are now being frequently used as a supplementary investigative tool for cardiovascular risk assessment (6,7).…”

Killing Me Unsoftly

“…In this respect, a recent ATVB study by Odri Komazec et al demonstrated significantly increased aortic stiffness in five- to seven-year-old children born at a gestational age <32 weeks, possibly due to inadequate elastin synthesis. 132 Thus, one could argue that those children are already born with significantly progressed arterial biological age.…”

Cardiovascular Immunotherapy and the Role of Imaging

“…24–26 Macrophages’ uncontrolled phagocytosis of LDL leads to the generation of foam cells, 27 inducing early stage plaque deposition in childhood. 13, 28 In advanced disease, the inflamed atherosclerotic plaque can rupture and induce an acute coronary syndrome or myocardial infarction. 7, 29–31 …”