AUTHOR=Chang Hung-Yang , Chang Jui-Hsing , Peng Chun-Chih , Hsu Chyong-Hsin , Ko Mary Hsin-Ju , Hung Chung-Lieh , Chen Ming-Ren 

TITLE=Subclinical Changes in Left Heart Structure and Function at Preschool Age in Very Low Birth Weight Preterm Infants

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.879952

DOI=10.3389/fcvm.2022.879952

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Survivors of preterm birth are at risk of long-term cardiovascular consequences. The objective of this prospective observational study was to assess left heart function at preschool age in preterm children with very low birth weight (VLBW).</p></sec><sec><title>Methods</title><p>We recruited children aged 5–6 years from preterm infants and full-term children. All subjects underwent conventional echocardiography and speckle-tracking echocardiography. The results were compared between the preterm and term groups.</p></sec><sec><title>Results</title><p>Eighty-seven VLBW preterm children and 29 term controls were included in the study. After adjusting for body surface area, the preterm group compared to the full-term group had significantly smaller left ventricular (LV) end-diastolic and end-systolic internal dimensions (31.2 vs. 33.5 mm, <italic>p</italic> = 0.048; and 20.0 vs. 21.6 mm, respectively; <italic>p</italic> = 0.024), lower LV end-diastolic and end-systolic volumes (38.8 vs. 46.3 mL, <italic>p</italic> = 0.024; and 12.8 vs. 15.6 mL, respectively; <italic>p</italic> = 0.008). Left atrial (LA) maximal and minimal volume were also significantly smaller in the preterm group (15.4 vs. 18.9 mL, <italic>p</italic> = 0.017; and 6.2 vs 7.5 mL, respectively; <italic>p</italic> = 0.018). LV global longitudinal strain (−21.4 vs. −23.2%, <italic>p</italic> &lt; 0.0001) and systolic strain rate (−1.30 vs. −1.37 /s, <italic>p</italic> = 0.001) were significantly lower in the preterm group than in the term control group. LA longitudinal strain was decreased (43.9 vs. 52.8%, <italic>p</italic> &lt; 0.0001) and left atrial stiffness index (0.17 vs. 0.14, <italic>p</italic> &lt; 0.0001) was increased in preterm infants. However, all the measurements in both groups were within normal range.</p></sec><sec><title>Conclusions</title><p>Subclinical changes of left heart structure and function were found in VLBW infants at preschool age. Additional long-term follow-ups of the cardiovascular outcomes are needed in this vulnerable population.</p></sec>