运动改善早产成人的心肌变形但不改变心脏结构：一项随机临床试验

Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults: A Randomized Clinical Trial.

作者信息

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

机构信息

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Faculty of Health Sciences, The National University of Malaysia, Kuala Lumpur, Malaysia.

出版信息

JACC Adv. 2025 Apr 28;4(5):101721. doi: 10.1016/j.jacadv.2025.101721.

DOI:10.1016/j.jacadv.2025.101721

PMID:40300305

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12063111/

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/m; 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.

摘要

背景

早产（妊娠<37周）出生的人具有潜在的不良心脏表型，且会随着血压升高而进展。

目的

作者调查了早产和足月出生的成年人在进行16周有氧运动干预后，是否表现出相似的心脏结构和功能重塑。

方法

我们对203名血压升高或患有1期高血压的成年人（年龄18 - 35岁）进行了一项随机对照试验。参与者按1:1随机分为16周有氧运动干预组或对照组。在一项预先指定的心血管磁共振成像（CMR）子研究中，使用3.0特斯拉磁共振成像评估干预前后左、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16周干预后完成了CMR扫描，其中运动干预组47人（足月出生26人；早产出生21人），对照组53人（足月出生32人；早产出生21人）。在足月出生的参与者中，运动干预组与对照组相比，左心室质量与舒张末期容积比降低（-3.43；95%CI：-6.29至-0.56；交互作用P = 0.027），右心室每搏输出量指数增加（5.53 mL/m；95%CI：2.60，8.47；交互作用P = 0.076）。在早产出生的参与者中，未观察到心脏结构指标有显著变化。在早产出生的参与者中，运动干预组与对照组相比，左心室基底和中间圆周应变增加（-1.33；95%CI：-2.07至-0.60；交互作用P = 0.057和-1.54；95%CI：-2.46至-0.63；交互作用P = 0.046），右心室整体纵向应变增加（1.99%；95%CI：-3.12至-0.87；交互作用P = 0.053）。在足月出生的参与者中，未观察到心肌变形参数有显著变化。