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Exercise improves CV health in adults born prematurely
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Patients who had CV impairments related to being born preterm and participated in a supervised exercise intervention had improved CV health and function, according to data presented at EuroCMR.
“Until now, it was not known if the sustained abnormal shape and function of the heart in young adults born very preterm were permanent or not,” Elizabeth Hillier, BSc, PhD candidate at McGill University Health Centre in Montreal, told Cardiology Today. “We have now for the first time shown that these cardiac changes may be amenable to improvement. Therefore, we hope that exercise in early adulthood may reduce the risks of cardiovascular disease in this population.”
Researchers analyzed data from 30 participants aged 18 to 29 years who were born very preterm (n = 12) or were healthy controls (n = 18). Both groups of participants participated in a supervised exercise intervention with resistance and aerobic training three times per week.
CV MRIs were performed at baseline and after 13 weeks to collect information on function and structural parameters, strain response to stress measurements, and global strain parameters.
“With this short, needle-free cardiac MRI technique, we can detect even mild abnormalities and track the response to interventions,” Hillier said in an interview. “Unlike other methods, we did not use any contrast or pharmacological stress agent to induce a predictable response of the heart to stress by a simple breathing maneuver: a period of hyperventilation followed by a breath-hold. We can visualize subtle regional changes in heart shape, oxygenation and function all in a 2-minute CMR protocol.”
At baseline CMR scan, the preterm group had reduced end-diastolic and endo-systolic volumes when compared with healthy participants (P < .05), both of which remained significant when indexed to height and body surface area.
The preterm and control groups had increases in myocardial mass after the intervention (P for both groups < .05).
Compared with the participants who were born very preterm, those in the control group had a more pronounced global peak longitudinal and circumferential strain response (P < .05), indicating functional deficits in the preterm population at rest. However, these functional differences were no longer significant after intervention, suggesting a functional improvement in the preterm group that was also improved in the sensitive marker of strain response to stress after breathing maneuver following the exercise intervention.
“We found that a short-term exercise program may improve overall cardiac performance as well as subtle cardiac function abnormalities in preterm adults,” Hillier told Cardiology Today. “We now need to determine the optimal exercise strategy to maximize benefits for the heart as well as overall exercise capacity of individuals born very preterm. We need to determine whether physical exercise needs to be part of the mandatory preventive and rehabilitation care for the long-term health of children and adolescents born preterm.” – by Darlene Dobkowski
Reference:
Hillier E, et al. Rapid Fire Abstract 4: Clinical Applications of Cardiac Function Phenotyping. Presented at: EuroCMR; May 2-4, 2019; Venice, Italy.
Disclosures: The study was funded by a research grant from the Heart and Stroke Foundation of Canada. Hillier reports no relevant financial disclosures. Another author reports he is board member and shareholder of Circle Cardiovascular Imaging and co-owns a patent on the evaluation of oxygenation-sensitive CMR images for diagnostic purposes.