Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults

JACC advances Pub Date : 2025-04-28 DOI:10.1016/j.jacadv.2025.101721

Winok Lapidaire PhD , Afifah Mohamed DPhil , Wilby Williamson DPhil , Odaro J. Huckstep DPhil , Maryam Alsharqi DPhil , Cheryl M.J. Tan DPhil , Samuel Burden PhD , Cameron Dockerill PhD , William Woodward BSc , Annabelle McCourt MSc , Holger Burchert DPhil , Yvonne Kenworthy BSc , Luca Biasiolli DPhil , Helen Dawes PhD , Charlie Foster PhD , Paul Leeson MB, PhD , Adam J. Lewandowski DPhil

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引用次数: 0

Abstract

Background

People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation.

Objectives

The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention.

Methods

We conducted a randomized controlled trial in 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension. Participants were randomized 1:1 to a 16-week aerobic exercise intervention or to a control group. In a prespecified cardiovascular magnetic resonance imaging (CMR) substudy, CMR was performed at 3.0-Tesla to assess left and right ventricular (LV and RV) structure and function before and after intervention.

Results

A total of 100 participants completed CMR scans at baseline and after the 16-week intervention, with n = 47 in the exercise intervention group (n = 26 term-born; n = 21 preterm-born) and n = 53 controls (n = 32 term-born; n = 21 preterm-born). In term-born participants, LV mass to end-diastolic volume ratio decreased (−3.43; 95% CI: −6.29 to −0.56; interaction P = 0.027) and RV stroke volume index increased (5.53 mL/m²; 95% CI: 2.60, 8.47; interaction P = 0.076) for those in the exercise intervention group vs controls. No significant effects were observed for cardiac structural indices in preterm-born participants. In preterm-born participants, LV basal- and mid-ventricular circumferential strain increased (−1.33; 95% CI: −2.07 to −0.60; interaction P = 0.057 and −1.54; 95% CI: −2.46 to −0.63; interaction P = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: −3.12 to −0.87; interaction P = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants.

Conclusions

Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.

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运动改善早产儿心肌变形，但不能改善心脏结构

背景：早产（妊娠37周）的人有潜在的不良心脏表型，随着血压升高而发展。目的研究16周有氧运动干预后，早产儿和足月成人是否表现出相似的心脏结构和功能重塑。方法我们对203例高血压或1期高血压患者（18-35岁）进行了随机对照试验。参与者按1:1的比例随机分为为期16周的有氧运动干预组和对照组。在预先指定的心血管磁共振成像（CMR）亚研究中，在3.0-Tesla下进行CMR以评估干预前后左、右心室（LV和RV）的结构和功能。结果共有100名参与者在基线和干预16周后完成了CMR扫描，其中运动干预组n = 47 （n = 26）足月出生；N = 21名早产儿)和N = 53名对照组(N = 32名早产儿；N = 21个早产儿)。在足月出生的参与者中，左室质量与舒张末期容积比下降(- 3.43；95% CI:−6.29 ~−0.56；交互作用P = 0.027)，右心室卒中容积指数升高(5.53 mL/m2；95% ci: 2.60, 8.47；相互作用P = 0.076)。未观察到早产儿心脏结构指标的显著影响。在早产儿中，左室基底和中心室周向应变增加(- 1.33；95% CI:−2.07 ~−0.60；交互作用P = 0.057和- 1.54；95% CI:−2.46 ~−0.63；相互作用P = 0.046)， RV整体纵向应变增大(1.99%；95% CI:−3.12 ~−0.87；相互作用P = 0.053)。在足月出生的参与者中没有观察到心肌变形参数的显著影响。结论有氧运动训练可改善早产儿心肌功能，但对心肌结构无改善作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC advances Cardiology and Cardiovascular Medicine

CiteScore

1.90

自引率

0.00%

发文量