Zachary W. Blair, Alvin Chandra, Gregory P. Barton, Nataly Sanchez Solano, Jarett D. Berry, Kara N. Goss
University of Texas Southwestern Medical Center. Parkland Health. University of Texas Health Tyler.
United States
Journal of the American Society of Echocardiography
J Am Soc Echocardiogr 2025;
DOI: 10.1016/j.echo.2025.04.007
Abstract
Background: Adults born premature have smaller cardiac chamber sizes, and some develop right ventricular (RV) dysfunction. Risk factors for RV dysfunction into adulthood remain unclear.
Objective: To investigate right-sided cardiac structure and function among adolescents and adults born preterm.
Methods: Participants born moderately to extremely premature (≤32 weeks) or very low birth weight (<1500 grams) aged 12-40 years were recruited from the Parkland Health Neonatal ICU registry. Healthy term-born similarly aged participants were recruited from Dallas County. Study visits included anthropometric measurements, a cardiopulmonary exam, and echocardiography. Multivariable linear regression models were used to determine the main effect of prematurity (yes or no) and gestational age on right atrial (RA) and RV structure and function after adjusting for age, sex, body surface area, and birthweight z-scores.
Results: Preterm participants (n=107) had a mean gestational age of 29.3 ± 2.7 weeks and mean birth weight of 1320 ± 398 g. Compared to term participants (n=48), echocardiography demonstrated smaller RA volume and RV area. Tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging systolic tricuspid annular peak velocity (RV s’), and early diastolic velocity (RV e’) were lower in preterm participants, with a significant dose response with gestational age and in the absence of overt pulmonary hypertension.
Conclusions: Right sided chamber sizes were smaller, with reduced TAPSE, RV s’, and RV e’ in adolescents and adults born premature, with a clear association with gestational age. Reduced RV function in the absence of overt pulmonary hypertension suggests preterm birth imparts an independent insult on the developing RV with lifetime implications.
Category
Right Heart Dysfunction Associated with Pulmonary Vascular Disease
Class III. Pulmonary Hypertension Associated with Lung Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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