Sixtus Ryan P, Dyson Rebecca M, Gray Clint L
Cardiff School of Biosciences, Cardiff, CF10 3US UK.
School of Biomedical Sciences, Newcastle, NSW Australia.
NPJ Cardiovasc Health. 2024;1(1):2. doi: 10.1038/s44325-024-00002-0. Epub 2024 Apr 5.
The aetiology of preterm cardiovascular disease formation appears different from that of traditional population. Within the 'traditional' population cardiovascular disease formation is driven by functional stressors (e.g., diet, smoking). Whereas preterm cardiovascular disease risk is driven by structural changes incurred at birth. Much of the proliferative growth in the developing heart and major vessels ceases at birth, leading to permanently reduced dimensions compared to their term-born cohort. These structural changes take a back seat to functional and clinical complications within the neonatal period, but become increasingly pronounced from adolescence, at which point functional decompensation can be observed. While the cause may differ from 'traditional' populations, the eventual disease outcomes do not, leading them to be an overlooked population. This means that aetiology, and thus, treatment options may be very different due to the underlying mechanisms. Here, we propose that the structural cause of preterm-associated cardiovascular disease is apparent and observable early in life. Understanding the differences in cardiovascular disease aetiology may therefore aid in the early treatment of preterm-associated cardiovascular disease risk.
早产相关心血管疾病形成的病因似乎与传统人群不同。在“传统”人群中，心血管疾病的形成是由功能性应激源（如饮食、吸烟）驱动的。而早产相关心血管疾病风险是由出生时发生的结构变化驱动的。发育中的心脏和主要血管的许多增殖性生长在出生时停止，导致与足月儿相比尺寸永久性减小。这些结构变化在新生儿期退居功能性和临床并发症之后，但从青春期开始变得越来越明显，此时可观察到功能失代偿。虽然病因可能与“传统”人群不同，但最终的疾病结果并无差异，这使得他们成为一个被忽视的人群。这意味着由于潜在机制的不同，病因以及治疗选择可能会有很大差异。在此，我们提出早产相关心血管疾病的结构病因在生命早期就很明显且可观察到。因此，了解心血管疾病病因的差异可能有助于早产相关心血管疾病风险的早期治疗。
