TY - JOUR
T1 - Blunted cardiac output response to exercise in adolescents born preterm
AU - Haraldsdottir, Kristin
AU - Watson, Andrew M.
AU - Pegelow, David F.
AU - Palta, Mari
AU - Tetri, Laura H.
AU - Levin, Taylor
AU - Brix, Melissa D.
AU - Centanni, Ryan M.
AU - Goss, Kara N.
AU - Eldridge, Marlowe M.
N1 - Funding Information:
Project supported by funding from the National Institutes of Health: 1R01 HL086897 (M.W.E.), and UW CVRC T32- HL 07936 (KH). The authors have no financial relations relevant to this article to disclose.
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: Premature birth is associated with lasting effects, including lower exercise capacity and pulmonary function, and is acknowledged as a risk factor for cardiovascular disease. The aim was to evaluate factors affecting exercise capacity in adolescents born preterm, including the cardiovascular and pulmonary responses to exercise, activity level and strength. Methods: 21 preterm-born and 20 term-born adolescents (age 12–14 years) underwent strength and maximal exercise testing with thoracic bioimpedance monitoring. Baseline variables were compared between groups and ANCOVA was used to compare heart rate, cardiac output (Q) and stroke volume (SV) during exercise between groups while adjusting for body surface area. Results: Preterm-borns had lower maximal aerobic capacity than term-borns (2.0 ± 0.5 vs. 2.5 ± 0.5 L/min, p = 0.01) and lower maximal power (124 ± 26 vs. 153 ± 33 watts, p < 0.01), despite similar physical activity scores. Pulmonary function and muscular strength did not differ significantly. Although baseline Q and SV did not differ between groups, preterm adolescents had significantly lower cardiac index (Qi) at 50, 75 and 100% of maximal time to exhaustion, driven by SV volume index (SVi, 50% max time: 53.0 ± 9.0 vs. 61.6 ± 11.4; 75%: 51.7 ± 8.4 vs. 64.3 ± 11.1; 100%: 51.2 ± 9.3 vs. 64.3 ± 11.5 ml/m2, all p < 0.01), with similar heart rates. Conclusion: Otherwise healthy and physically active adolescents born very preterm exhibit lower exercise capacity than term-born adolescents. Despite similar baseline cardiovascular values, preterm-born adolescents demonstrate significantly reduced Qi and SVi during incremental and maximal exercise.
AB - Purpose: Premature birth is associated with lasting effects, including lower exercise capacity and pulmonary function, and is acknowledged as a risk factor for cardiovascular disease. The aim was to evaluate factors affecting exercise capacity in adolescents born preterm, including the cardiovascular and pulmonary responses to exercise, activity level and strength. Methods: 21 preterm-born and 20 term-born adolescents (age 12–14 years) underwent strength and maximal exercise testing with thoracic bioimpedance monitoring. Baseline variables were compared between groups and ANCOVA was used to compare heart rate, cardiac output (Q) and stroke volume (SV) during exercise between groups while adjusting for body surface area. Results: Preterm-borns had lower maximal aerobic capacity than term-borns (2.0 ± 0.5 vs. 2.5 ± 0.5 L/min, p = 0.01) and lower maximal power (124 ± 26 vs. 153 ± 33 watts, p < 0.01), despite similar physical activity scores. Pulmonary function and muscular strength did not differ significantly. Although baseline Q and SV did not differ between groups, preterm adolescents had significantly lower cardiac index (Qi) at 50, 75 and 100% of maximal time to exhaustion, driven by SV volume index (SVi, 50% max time: 53.0 ± 9.0 vs. 61.6 ± 11.4; 75%: 51.7 ± 8.4 vs. 64.3 ± 11.1; 100%: 51.2 ± 9.3 vs. 64.3 ± 11.5 ml/m2, all p < 0.01), with similar heart rates. Conclusion: Otherwise healthy and physically active adolescents born very preterm exhibit lower exercise capacity than term-born adolescents. Despite similar baseline cardiovascular values, preterm-born adolescents demonstrate significantly reduced Qi and SVi during incremental and maximal exercise.
KW - Aerobic capacity
KW - Cardiac output
KW - Cardiovascular disease
KW - Exercise capacity
KW - Pediatric exercise physiology
KW - Physical activity
KW - Premature birth
KW - Preterm birth
KW - Stroke index
KW - Thoracic bioimpedance
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U2 - 10.1007/s00421-020-04480-9
DO - 10.1007/s00421-020-04480-9
M3 - Article
C2 - 32862247
AN - SCOPUS:85089974287
VL - 120
SP - 2547
EP - 2554
JO - European Journal of Applied Physiology
JF - European Journal of Applied Physiology
SN - 1439-6319
IS - 11
ER -