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

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 re...

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Autores principales: Lewandowski, Adam J., Levy, Philip T., Bates, Melissa L., McNamara, Patrick J., Nuyt, Anne Monique, Goss, Kara N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480939/
https://www.ncbi.nlm.nih.gov/pubmed/32816574
http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.15574
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author Lewandowski, Adam J.
Levy, Philip T.
Bates, Melissa L.
McNamara, Patrick J.
Nuyt, Anne Monique
Goss, Kara N.
author_facet Lewandowski, Adam J.
Levy, Philip T.
Bates, Melissa L.
McNamara, Patrick J.
Nuyt, Anne Monique
Goss, Kara N.
author_sort Lewandowski, Adam J.
collection PubMed
description 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.
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spelling pubmed-74809392020-09-24 Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk Lewandowski, Adam J. Levy, Philip T. Bates, Melissa L. McNamara, Patrick J. Nuyt, Anne Monique Goss, Kara N. Hypertension Reviews 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. Lippincott Williams & Wilkins 2020-08-17 2020-10 /pmc/articles/PMC7480939/ /pubmed/32816574 http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.15574 Text en © 2020 The Authors. Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
spellingShingle Reviews
Lewandowski, Adam J.
Levy, Philip T.
Bates, Melissa L.
McNamara, Patrick J.
Nuyt, Anne Monique
Goss, Kara N.
Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
title Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
title_full Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
title_fullStr Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
title_full_unstemmed Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
title_short Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk
title_sort impact of the vulnerable preterm heart and circulation on adult cardiovascular disease risk
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480939/
https://www.ncbi.nlm.nih.gov/pubmed/32816574
http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.15574
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