Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA; Georgia Prevention Institute, Augusta University, Augusta, GA, USA.
Early Hum Dev. 2019 May;132:24-29. doi: 10.1016/j.earlhumdev.2019.03.018. Epub 2019 Apr 3.
Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy.
To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length and Ponderal index (PI); weight/length) at birth on one hand, with left ventricular (LV) structure and function during adolescence.
379 healthy adolescents aged 14-18 years in Augusta, Georgia.
LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography.
When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (P = 0.04) was identified.
Our adolescent data suggest that proportionality at birth may identify associations between perinatal growth and cardiac remodeling independent of birthweight alone.
围产期生长对心脏发育有重要影响。低出生体重与心血管（CV）事件和死亡率相关，动物研究表明，胎儿生长受限与围产期的心脏重构相关，导致心肌细胞供应的永久性丧失和代偿性肥大。
确定出生体重（BW）和多种比例指数（体重指数（BMI）；体重/长度和彭德尔指数（PI）；体重/长度）与青少年时期左心室（LV）结构和功能的关联。
佐治亚州奥古斯塔的 379 名健康青少年，年龄在 14-18 岁之间。
通过超声心动图评估 LV 结构和功能参数，包括舒张期室间隔厚度（IVSd）、舒张期左室内径（LVIDd）、收缩期左室内径（LVIDs）、舒张期左室后壁厚度（LVPWd）、相对壁厚度（RWT）、中层短缩分数（MFS）和射血分数。
当分别用线性回归调整年龄、性别、种族、Tanner 分期、社会经济地位和体力活动后，出生体重、出生 BMI 和出生 PI 与 LV 结构和功能参数的关联进行评估时，发现 BW 与 LVIDd 呈显著正相关（P=0.004），出生 BMI 与 LV 质量指数（P=0.01），出生 PI 与 IVSd（P=0.02）、LVPWd（P=0.03）和 LV 质量指数（P=0.002）呈显著正相关。当根据 PI 三分位将 LV 结构和功能参数进行比较时，LV 质量指数呈显著的 U 形趋势（P=0.04）。
我们的青少年数据表明，出生时的比例性可能会确定围产期生长与心脏重构之间的关联，而不仅仅是出生体重。
