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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Lewandowski DPhil","doi":"10.1016/j.jacadv.2025.101721","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation.</div></div><div><h3>Objectives</h3><div>The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>P</em> = 0.027) and RV stroke volume index increased (5.53 mL/m<sup>2</sup>; 95% CI: 2.60, 8.47; interaction <em>P</em> = 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 <em>P</em> = 0.057 and −1.54; 95% CI: −2.46 to −0.63; interaction <em>P</em> = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: −3.12 to −0.87; interaction <em>P</em> = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants.</div></div><div><h3>Conclusions</h3><div>Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 5","pages":"Article 101721"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults\",\"authors\":\"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\",\"doi\":\"10.1016/j.jacadv.2025.101721\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation.</div></div><div><h3>Objectives</h3><div>The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>P</em> = 0.027) and RV stroke volume index increased (5.53 mL/m<sup>2</sup>; 95% CI: 2.60, 8.47; interaction <em>P</em> = 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 <em>P</em> = 0.057 and −1.54; 95% CI: −2.46 to −0.63; interaction <em>P</em> = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: −3.12 to −0.87; interaction <em>P</em> = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants.</div></div><div><h3>Conclusions</h3><div>Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.</div></div>\",\"PeriodicalId\":73527,\"journal\":{\"name\":\"JACC advances\",\"volume\":\"4 5\",\"pages\":\"Article 101721\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772963X25001383\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772963X25001383","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults
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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