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Manferdelli G, Narang BJ, Bourdillon N, Debevec T, Millet GP. Physiological Responses to Exercise in Hypoxia in Preterm Adults: Convective and Diffusive Limitations in the O 2 Transport. Med Sci Sports Exerc 2023; 55:482-496. [PMID: 36459101 DOI: 10.1249/mss.0000000000003077] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
PURPOSE Premature birth induces long-term sequelae on the cardiopulmonary system, leading to reduced exercise capacity. However, the mechanisms of this functional impairment during incremental exercise remain unclear. Also, a blunted hypoxic ventilatory response was found in preterm adults, suggesting an increased risk for adverse effects of hypoxia in this population. This study aimed to investigate the oxygen cascade during incremental exercise to exhaustion in both normoxia and hypobaric hypoxia in prematurely born adults with normal lung function and their term born counterparts. METHODS Noninvasive measures of gas exchange, cardiac hemodynamics, and both muscle and cerebral oxygenation were continuously performed using metabolic cart, transthoracic impedance, and near-infrared spectroscopy, respectively, during an incremental exercise test to exhaustion performed at sea level and after 3 d of high-altitude exposure in healthy preterm ( n = 17; gestational age, 29 ± 1 wk; normal lung function) and term born ( n = 17) adults. RESULTS At peak, power output, oxygen uptake, stroke volume indexed for body surface area, and cardiac output were lower in preterm compared with term born in normoxia ( P = 0.042, P = 0.027, P = 0.030, and P = 0.018, respectively) but not in hypoxia, whereas pulmonary ventilation, peripheral oxygen saturation, and muscle and cerebral oxygenation were similar between groups. These later parameters were modified by hypoxia ( P < 0.001). Hypoxia increased muscle oxygen extraction at submaximal and maximal intensity in term born ( P < 0.05) but not in preterm participants. Hypoxia decreased cerebral oxygen saturation in term born but not in preterm adults at rest and during exercise ( P < 0.05). Convective oxygen delivery was decreased by hypoxia in term born ( P < 0.001) but not preterm adults, whereas diffusive oxygen transport decreased similarly in both groups ( P < 0.001 and P < 0.001, respectively). CONCLUSIONS These results suggest that exercise capacity in preterm is primarily reduced by impaired convective, rather than diffusive, oxygen transport. Moreover, healthy preterm adults may experience blunted hypoxia-induced impairments during maximal exercise compared with their term counterparts.
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Affiliation(s)
| | | | - Nicolas Bourdillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, SWITZERLAND
| | | | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, SWITZERLAND
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Xu JH, Bariciak E, Harrison MA, Broom M, Lemyre B, Webster RJ, Weiler G, Dahlstrom JE, Kent A. Normative values of renin and aldosterone in clinically stable preterm neonates. Pediatr Nephrol 2022; 38:1877-1886. [PMID: 36409371 PMCID: PMC10154272 DOI: 10.1007/s00467-022-05807-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a paucity of literature on the normative levels of plasma renin concentration (PRC) and serum aldosterone (SA) in premature neonates. This study aims to provide normative data on PRC and SA levels in preterm neonates in the first 2 weeks after birth and explore associations with maternal, perinatal, or postnatal factors. METHODS Neonates born at 26- to 34-week gestation were recruited from two neonatal intensive care units in Canada and Australia. The direct renin assay PRC and SA were analyzed on day 1 and days 14-21 after birth to compare across categorical variables and to produce normative values. RESULTS A total of 262 subjects were enrolled from the Canadian (29%) and Australian (71%) sites. The mean gestational age was 30 weeks, with a mean birth weight of 1457 g. The normative values of PRC and SA for neonates born between 26 + 0 and 29 + 6 weeks and 30 + 0 and 34 + 0 weeks of gestation were produced for day 1 and day 14-21 after birth. Both PRC and SA increased from day 1 to day 14-21. The more premature neonates reached a higher PRC on days 14-21 after birth but exhibited lower SA levels on day 1 after birth. When comparing gender, birth weight, and maternal risk factor categories, no statistical differences in PRC or SA were found. A small but significant decrease in PRC, but not SA, was noted for neonates with placental pathology. CONCLUSIONS This study produced normative values of PRA and SA in clinically stable preterm neonates that can be referenced for use in clinical practice. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- James Haiyang Xu
- Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Erika Bariciak
- Division of Neonatology, Children's Hospital of Eastern Ontario and The Ottawa Hospital General Campus, Ottawa, Canada
| | - Mary-Ann Harrison
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Margaret Broom
- Dept of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, ACT Australia, SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, ACT, Canberra, Australia
| | - Brigitte Lemyre
- Division of Neonatology, Children's Hospital of Eastern Ontario and The Ottawa Hospital General Campus, Ottawa, Canada
| | - Richard J Webster
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Gabrielle Weiler
- Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Jane E Dahlstrom
- Dept of Anatomical Pathology, Canberra Hospital, ACT Australia, Australian National University, Canberra, ACT, Australia
| | - Alison Kent
- Department of Pediatrics, University of Rochester, Rochester, NY, USA. .,Australian National University, Canberra, ACT, Australia.
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Yang H, Wang Y, Tang MC, Waters P, Wang S, Allard P, Ryan RO, Nuyt AM, Paradis P, Schiffrin EL, Furtos A, Mitchell GA. Cardiac-specific deficiency of 3-hydroxy-3-methylglutaryl coenzyme A lyase in mice causes cardiomyopathy and a distinct pattern of acyl-coenzyme A-related biomarkers. Mol Genet Metab 2022; 137:257-264. [PMID: 36228350 DOI: 10.1016/j.ymgme.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 10/31/2022]
Abstract
Deficiency of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) lyase (HL) is an autosomal recessive inborn error of acyl-CoA metabolism affecting the last step of leucine degradation. Patients with HL deficiency (HLD) can develop a potentially fatal cardiomyopathy. We created mice with cardiomyocyte-specific HLD (HLHKO mice), inducing Cre recombinase-mediated deletion of exon 2 at two months of age. HLHKO mice survive, but develop left ventricular hypertrophy by 9 months. Also, within minutes after intraperitoneal injection of the leucine metabolite 2-ketoisocaproate (KIC), they show transient left ventricular hypocontractility and dilation. Leucine-related acyl-CoAs were elevated in HLHKO heart (e.g., HMG-CoA, 34.0 ± 4.4 nmol/g versus 0.211 ± 0.041 in controls, p < 0.001; 3-methylcrotonyl-CoA, 5.84 ± 0.69 nmol/g versus 0.282 ± 0.043, p < 0.001; isovaleryl-CoA, 1.86 ± 0.30 nmol/g versus 0.024 ± 0.014, p < 0.01), a similar pattern to that in liver of mice with hepatic HL deficiency. After KIC loading, HMG-CoA levels in HLHKO heart were higher than under basal conditions, as were the ratios of HMG-CoA/acetyl-CoA and of HMG-CoA/succinyl-CoA. In contrast to the high levels of multiple leucine-related acyl-CoAs, biomarkers in urine and plasma of HLHKO mice show isolated hyper-3-methylglutaconic aciduria (700.8 ± 48.4 mmol/mol creatinine versus 37.6 ± 2.4 in controls, p < 0.001), and elevated C5-hydroxyacylcarnitine in plasma (0.248 ± 0.014 μmol/L versus 0.048 ± 0.005 in controls, p < 0.001). Mice with liver-specific HLD were compared, and showed normal echocardiographic findings and normal acyl-CoA profiles in heart. This study of nonhepatic tissue-specific HLD outside of liver reveals organ-specific origins of diagnostic biomarkers for HLD in blood and urine and shows that mouse cardiac HL is essential for myocardial function in a cell-autonomous, organ-autonomous fashion.
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Affiliation(s)
- Hao Yang
- Medical Genetics Service, Department of Pediatrics and Research Center, CHU Sainte-Justine and Université de Montréal, Montreal, Québec, Canada
| | - Youlin Wang
- Medical Genetics Service, Department of Pediatrics and Research Center, CHU Sainte-Justine and Université de Montréal, Montreal, Québec, Canada
| | | | - Paula Waters
- Medical Genetics Service, Department of Laboratory Medicine, CHU Sherbrooke and Department of Pediatrics, Université de Sherbrooke, Québec, Canada
| | - Shupei Wang
- Medical Genetics Service, Department of Pediatrics and Research Center, CHU Sainte-Justine and Université de Montréal, Montreal, Québec, Canada
| | - Pierre Allard
- Biochemical Genetics Laboratory, CHU Sainte-Justine, Montreal, Québec, Canada
| | - Robert O Ryan
- Department of Biochemistry and Molecular Biology, University of Nevada, Reno, Reno, NV, United States
| | - Anne-Monique Nuyt
- Sainte-Justine University Hospital and Research Center, University of Montreal, Montreal, Québec, Canada
| | - Pierre Paradis
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Québec, Canada
| | - Ernesto L Schiffrin
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Québec, Canada
| | - Alexandra Furtos
- Département de Chimie, Université de Montréal, Montreal, Québec, Canada
| | - Grant A Mitchell
- Medical Genetics Service, Department of Pediatrics and Research Center, CHU Sainte-Justine and Université de Montréal, Montreal, Québec, Canada.
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Exposure to high levels of oxygen in neonatal rats induce a decrease in hemoglobin levels. Pediatr Res 2022; 92:430-435. [PMID: 34718354 DOI: 10.1038/s41390-021-01802-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/26/2021] [Accepted: 10/10/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Anemia of prematurity is common in extremely preterm neonates, and oxygen exposure may participate to anemia by inhibiting erythropoietin secretion. We aimed to determine whether hyperoxia exerts an independent role in the occurrence of the anemia of prematurity. METHODS Sprague-Dawley pups were exposed to 80% oxygen or room air from days 3 to 10 of life. Main outcome was the difference in hemoglobin and circulating erythropoietin levels in animals exposed to hyperoxia at 10 days of life. We performed a complete blood count analysis using fluorescent laser flow cytometry and measured circulating erythropoietin levels using ELISA. RESULTS We found lower hemoglobin in the hyperoxia group, compared to the normoxia group, both in males (70 ± 3 versus 78 ± 2 g/l) and in females (71 ± 2 versus 81 ± 3 g/l) at 10 days of life. Reticulocyte count was not increased in the hyperoxia group. Circulating erythropoietin levels were lower at 10 days of life in the animals exposed to hyperoxia, both in males (33 ± 7 versus 73 ± 6 pg/ml) and in females (37 ± 5 versus 66 ± 3 pg/ml), but were similar at 28 days of life. CONCLUSION Neonatal exposure to hyperoxia decreases hematopoiesis in rats. IMPACT Mechanisms leading to anemia of prematurity are not well known and their study in humans is complicated due to multiple confounders. This study shows for the first time that exposure to high concentrations of oxygen in the neonatal period decreases hematopoiesis in rats, providing insight on the pathophysiological mechanisms of the anemia of prematurity. This research paves the way for future therapeutic developments aiming to reduce the burden of anemia of prematurity and the necessity of red blood cell transfusions in extremely preterm neonates.
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Bertagnolli M, Dartora DR, Lamata P, Zacur E, Mai-Vo TA, He Y, Beauchamp L, Lewandowski AJ, Cloutier A, Sutherland MR, Santos RAS, Nuyt AM. Reshaping the Preterm Heart: Shifting Cardiac Renin-Angiotensin System Towards Cardioprotection in Rats Exposed to Neonatal High-Oxygen Stress. Hypertension 2022; 79:1789-1803. [PMID: 35588210 PMCID: PMC9278707 DOI: 10.1161/hypertensionaha.122.19115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Approximately 10% of infants are born preterm. Preterm birth leads to short and long-term changes in cardiac shape and function. By using a rat model of neonatal high-oxygen (80%O2) exposure, mimicking the premature hyperoxic transition to the extrauterine environment, we revealed a major role of the renin-angiotensin system peptide Angio II (angiotensin II) and its receptor AT1 (angiotensin receptor type 1) on neonatal O2-induced cardiomyopathy. Here, we tested whether treatment with either orally active compounds of the peptides Angio-(1-7) or alamandine included in cyclodextrin could prevent postnatal cardiac remodeling and the programming of cardiomyopathy induced by neonatal high-O2 exposure. METHODS Sprague-Dawley pups were exposed to room air or 80% O2 from postnatal day 3 (P3) to P10. Neonatal rats were treated orally from P3 to P10 and assessed at P10 and P28. Left ventricular (LV) shapes were characterized by tridimensional computational atlases of ultrasound images in addition to histomorphometry. RESULTS At P10, high O2-exposed rats presented a smaller, globular and hypertrophied LV shape versus controls. Treatment with cyclodextrin-Angio-(1-7) significantly improved LV function in the O2-exposed neonatal rats and slightly changed LV shape. Cyclodextrin-alamandine and cyclodextrin-Angio-(1-7) treatments similarly reduced hypertrophy at P10 as well as LV remodeling and dysfunction at P28. Both treatments upregulated cardiac angiotensin-converting enzyme 2 in O2-exposed rats at P10 and P28. CONCLUSIONS Our findings demonstrate LV remodeling changes induced by O2-stress and the potential benefits of treatments targeting the cardioprotective renin-angiotensin system axis, supporting the neonatal period as an important window for interventions aiming at preventing cardiomyopathy in people born preterm.
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Affiliation(s)
- Mariane Bertagnolli
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.).,Research Center of the Hospital Sacré-Coeur, CIUSSS Nord-de-l'Île-de-Montréal, Canada (M.B.).,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal, Canada (M.B.)
| | - Daniela R Dartora
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.).,Instituto de Cardiologia de Porto Alegre, Fundação Universitária de Cardiologia, Brazil (D.R.D.)
| | - Pablo Lamata
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (P.L., E.Z.)
| | - Ernesto Zacur
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (P.L., E.Z.)
| | - Thuy-An Mai-Vo
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.)
| | - Ying He
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.)
| | - Léonie Beauchamp
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.)
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (A.J.L.)
| | - Anik Cloutier
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.)
| | - Megan R Sutherland
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.).,Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia (M.R.S.)
| | - Robson A S Santos
- Department of Physiology, Instituto Nacional de Ciência e Tecnologia - Nanobiofar, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (R.A.S.S.)
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital Research Center, Université de Montréal, Canada (M.B., D.R.D., T.-A.M.-V., Y.H., L.B., A.C., M.R.S., A.M.N.)
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Ravizzoni Dartora D, Flahault A, Pontes CNR, He Y, Deprez A, Cloutier A, Cagnone G, Gaub P, Altit G, Bigras JL, Joyal JS, Mai Luu T, Burelle Y, Nuyt AM. Cardiac Left Ventricle Mitochondrial Dysfunction After Neonatal Exposure to Hyperoxia: Relevance for Cardiomyopathy After Preterm Birth. Hypertension 2021; 79:575-587. [PMID: 34961326 PMCID: PMC8823906 DOI: 10.1161/hypertensionaha.121.17979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. Individuals born preterm present left ventricle changes and increased risk of cardiac diseases and heart failure. The pathophysiology of heart disease after preterm birth is incompletely understood. Mitochondria dysfunction is a hallmark of cardiomyopathy resulting in heart failure. We hypothesized that neonatal hyperoxia in rats, a recognized model simulating preterm birth conditions and resulting in oxygen-induced cardiomyopathy, induce left ventricle mitochondrial changes in juvenile rats. We also hypothesized that humanin, a mitochondrial-derived peptide, would be reduced in young adults born preterm.
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Affiliation(s)
- Daniela Ravizzoni Dartora
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Adrien Flahault
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Carolina N R Pontes
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.).,Department of Physiology and Pharmacology, Universidade Federal de Goias, Brazil (C.N.R.P.)
| | - Ying He
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Alyson Deprez
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Anik Cloutier
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Gaël Cagnone
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.).,Department of Physiology and Pharmacology, Faculty of Medicine, University of Montreal, Quebec, Canada. (G.C., P.G., J.-S.J.)
| | - Perrine Gaub
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.).,Department of Physiology and Pharmacology, Faculty of Medicine, University of Montreal, Quebec, Canada. (G.C., P.G., J.-S.J.)
| | - Gabriel Altit
- Division of Neonatology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada (G.A.)
| | - Jean-Luc Bigras
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Jean-Sébastien Joyal
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.).,Department of Physiology and Pharmacology, Faculty of Medicine, University of Montreal, Quebec, Canada. (G.C., P.G., J.-S.J.)
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
| | - Yan Burelle
- Department of Cellular and Molecular Medicine, University of Ottawa, Canada (Y.B.)
| | - Anne Monique Nuyt
- Department of Pediatrics, Sainte-Justine University Hospital (CHU Sainte-Justine) and Research Centre, Faculty of Medicine, University of Montreal, Quebec, Canada. (D.R.D., A.F., C.N.R.P., Y.H., A.D., A.C., G.C., P.G., J.-L.B., J.-S.J., T.M.L., A.M.N.)
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Effect of Preterm Birth on Cardiac and Cardiomyocyte Growth and the Consequences of Antenatal and Postnatal Glucocorticoid Treatment. J Clin Med 2021; 10:jcm10173896. [PMID: 34501343 PMCID: PMC8432182 DOI: 10.3390/jcm10173896] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 12/18/2022] Open
Abstract
Preterm birth coincides with a key developmental window of cardiac growth and maturation, and thus has the potential to influence long-term cardiac function. Individuals born preterm have structural cardiac remodelling and altered cardiac growth and function by early adulthood. The evidence linking preterm birth and cardiovascular disease in later life is mounting. Advances in the perinatal care of preterm infants, such as glucocorticoid therapy, have improved survival rates, but at what cost? This review highlights the short-term and long-term impact of preterm birth on the structure and function of the heart and focuses on the impact of antenatal and postnatal glucocorticoid treatment on the immature preterm heart.
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8
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Lewandowski AJ, Raman B, Bertagnolli M, Mohamed A, Williamson W, Pelado JL, McCance A, Lapidaire W, Neubauer S, Leeson P. Association of Preterm Birth With Myocardial Fibrosis and Diastolic Dysfunction in Young Adulthood. J Am Coll Cardiol 2021; 78:683-692. [PMID: 34384550 PMCID: PMC8363934 DOI: 10.1016/j.jacc.2021.05.053] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/23/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023]
Abstract
Background Preterm birth affects about 10% of live births worldwide and is associated with cardiac alterations. Animal models of preterm birth suggest that left ventricular functional impairment may be due to an up-regulation of myocardial fibrosis. Objectives The aim of this study was to determine whether diffuse left ventricular fibrosis is evident in young adults born preterm. Methods One hundred one normotensive young adults born preterm (n = 47, mean gestational age 32.8 ± 3.2 weeks) and term (n = 54) were included from YACHT (Young Adult Cardiovascular Health sTudy). Left ventricular structure and function were quantified by cardiovascular magnetic resonance and echocardiography. Intravenous administration of a gadolinium-based contrast agent during cardiovascular magnetic resonance was used to quantify focal myocardial fibrosis on the basis of late gadolinium enhancement and, in combination with T1 mapping, to quantify diffuse myocardial fibrosis on the basis of assessment of myocardial extracellular volume fraction. Results Adults born preterm had smaller left ventricular end-diastolic and stroke volumes, with greater left ventricular mass and wall thickness (P < 0.001). In addition, longitudinal peak systolic strain and diastolic strain rate by both cardiovascular magnetic resonance and echocardiography, and E/A ratio measured by echocardiography, were lower in preterm-born compared to term-born adults (P < 0.05). Extracellular volume fraction was greater in preterm-born compared with term-born adults (27.81% ± 1.69% vs 25.48% ± 1.41%; P < 0.001) and was a significant mediator in the relationship between gestational age and both longitudinal peak diastolic strain rate and E/A ratio. Conclusions Preterm-born young adults have greater extracellular volume fraction in the left ventricle that is inversely related with gestational age and may underlie their diastolic functional impairments.
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Affiliation(s)
- Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom; Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
| | - Betty Raman
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Mariane Bertagnolli
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom; Hôpital du Sacré-Cœur de Montréal Research Center (CIUSSS Nord-de-l'Île-de-Montréal), School of Physical and Occupational Therapy, McGill University, Montréal, Quebec, Canada
| | - Afifah Mohamed
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom; Department of Diagnostic Imaging & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wilby Williamson
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom
| | - Joana Leal Pelado
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Angus McCance
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom
| | - Winok Lapidaire
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom
| | - Stefan Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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9
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Mohamed A, Marciniak M, Williamson W, Huckstep OJ, Lapidaire W, McCance A, Neubauer S, Leeson P, Lewandowski AJ. Association of Systolic Blood Pressure Elevation With Disproportionate Left Ventricular Remodeling in Very Preterm-Born Young Adults: The Preterm Heart and Elevated Blood Pressure. JAMA Cardiol 2021; 6:821-829. [PMID: 33978675 PMCID: PMC8117059 DOI: 10.1001/jamacardio.2021.0961] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Question Are left ventricular structure and function in preterm-born adults more susceptible to remodeling in association with blood pressure elevation? Findings In this cross-sectional cohort study of 468 adults with cardiac magnetic resonance imaging, left ventricular mass index and mass to end-diastolic volume ratio were greater for each 1–mm Hg elevation in systolic blood pressure in preterm-born adults than in term-born adults, with the greatest rise in those born very and extremely preterm (<32 weeks’ gestation). Meaning The findings of this study show that adults born preterm demonstrate greater remodeling in response to systolic blood pressure elevation and may require earlier interventions to prevent cardiovascular disease progression. Importance Preterm-born individuals have higher blood pressure with an increased risk of hypertension by young adulthood, as well as potentially adverse cardiac remodeling even when normotensive. To what extent blood pressure elevation affects left ventricular (LV) structure and function in adults born preterm is currently unknown. Objective To investigate whether changes observed in LV structure and function in preterm-born adults make them more susceptible to cardiac remodeling in association with blood pressure elevation. Design, Setting, and Participants This cross-sectional cohort study, conducted at the Oxford Cardiovascular Clinical Research Facility and Oxford Centre for Clinical Magnetic Resonance Research, included 468 adults aged 18 to 40 years. Of these, 200 were born preterm (<37 weeks’ gestation) and 268 were born at term (≥37 weeks’ gestation). Cardiac magnetic resonance imaging was used to characterize LV structure and function, with clinical blood pressure readings measured to assess hypertension status. Demographic and anthropometric data, as well as birth history and family medical history information, were collected. Data were analyzed between January 2012 and February 2021. Main Outcomes and Measures Cardiac magnetic resonance measures of LV structure and function in response to systolic blood pressure elevation. Results The cohort was primarily White (>95%) with a balanced sex distribution (51.5% women and 48.5% men). Preterm-born adults with and without hypertension had higher LV mass index, reduced LV function, and smaller LV volumes compared with term-born individuals both with and without hypertension. In regression analyses of systolic blood pressure with LV mass index and LV mass to end-diastolic volume ratio, there was a leftward shift in the slopes in preterm-born compared with term-born adults. Compared with term-born adults, there was a 2.5-fold greater LV mass index per 1–mm Hg elevation in systolic blood pressure in very and extremely preterm-born adults (<32 weeks’ gestation) (0.394 g/m2 vs 0.157 g/m2 per 1 mm Hg; P < .001) and a 1.6-fold greater LV mass index per 1–mm Hg elevation in systolic blood pressure in moderately preterm-born adults (32 to 36 weeks’ gestation) (0.250 g/m2 vs 0.157 g/m2 per 1 mm Hg; P < .001). The LV mass to end-diastolic volume ratio per 1–mm Hg elevation in systolic blood pressure in the very and extremely preterm-born adults was 3.4-fold greater compared with those born moderately preterm (3.56 × 10−3 vs 1.04 × 10−3 g/mL per 1 mm Hg; P < .001) and 3.3-fold greater compared with those born at term (3.56 × 10−3 vs 1.08 × 10−3 g/mL per 1 mm Hg; P < .001). Conclusions and Relevance Preterm-born adults have a unique LV structure and function that worsens with systolic blood pressure elevation. Additional primary prevention strategies specifically targeting cardiovascular risk reduction in this population may be warranted.
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Affiliation(s)
- Afifah Mohamed
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England.,Department of Diagnostic Imaging & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Oxford University Hospitals NHS Foundation Trust, Oxford, England
| | - Maciej Marciniak
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, England
| | - Wilby Williamson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England
| | - Odaro J Huckstep
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England.,Department of Biology, United States Air Force Academy, Air Force Academy, Colorado
| | - Winok Lapidaire
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England.,Oxford University Hospitals NHS Foundation Trust, Oxford, England
| | - Angus McCance
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England.,Oxford University Hospitals NHS Foundation Trust, Oxford, England
| | - Stefan Neubauer
- Oxford University Hospitals NHS Foundation Trust, Oxford, England.,Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England.,Oxford University Hospitals NHS Foundation Trust, Oxford, England
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England.,Oxford University Hospitals NHS Foundation Trust, Oxford, England.,Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, England
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10
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Left Ventricle Structure and Function in Young Adults Born Very Preterm and Association with Neonatal Characteristics. J Clin Med 2021; 10:jcm10081760. [PMID: 33919540 PMCID: PMC8072582 DOI: 10.3390/jcm10081760] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/19/2022] Open
Abstract
Preterm birth increases risk of cardiovascular disease and early death. A body of evidence suggests left ventricle (LV) echocardiographic alterations in children and adults born preterm. We aimed to determine if neonatal characteristics were associated with alterations in LV structure and function in preterm adults. We evaluated a cohort of 86 young adults born preterm below 30 weeks of gestation, and 85 full-term controls. We determined LV dimensions and function using tissue Doppler imaging, conventional and speckle tracking echocardiography (STE). Adults born preterm had smaller LV dimensions, but these differences did not remain after adjustment for body surface area (BSA), which was smaller in the preterm group. Stroke volume and cardiac output were reduced even after adjustment for BSA. We found a smaller e’ wave in the preterm group, but other markers of systolic and diastolic function did not differ. Use of antenatal steroids may be associated with a further reduced cardiac output in those born preterm. Adults born preterm show alterations in markers of LV dimensions and function. Identification of these markers may represent opportunities for early prevention of cardiovascular events in this at-risk population.
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11
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Zhang L, Zhang B, Yu Y, Wang J, Wu J, Su Y, Jiang H, Zou Y, Ge J. Angiotensin II Increases HMGB1 Expression in the Myocardium Through AT1 and AT2 Receptors When Under Pressure Overload. Int Heart J 2021; 62:162-170. [PMID: 33455985 DOI: 10.1536/ihj.20-384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
High-mobility group box 1 (HMGB1) is increased in the myocardium under pressure overload (PO) and is involved in PO-induced cardiac remodeling. The mechanisms of the upregulation of cardiac HMGB1 expression have not been fully elucidated. In the present study, a mouse transverse aortic constriction (TAC) model was used, and an angiotensin II (Ang II) type 1 (AT1) receptor inhibitor (losartan) or Ang II type 2 (AT2) receptor inhibitor (PD123319) was administrated to mice for 14 days. Cardiac myocytes were cultured and treated with Ang II for 5 minutes to 48 hours conditionally with the blockage of the AT1 or AT2 receptor. TAC-induced cardiac hypertrophy was observed at 14 days after the operation, which was partially reversed by losartan, but not by PD123319. Similarly, the upregulated HMGB1 expression levels observed in both the serum and myocardium induced by TAC were reduced by losartan. Elevated cardiac HMGB1 protein levels, but not mRNA or serum levels, were significantly decreased by PD123319. Furthermore, HMGB1 expression levels in culture media and cardiac myocytes were increased following Ang II treatment in vitro, positively associated with the duration of treatment. Similarly, Ang II-induced upregulation of HMGB1 in vitro was inhibited by both losartan and PD123319. These results suggest that upregulation of HMGB1 in serum and myocardium under PO, which are partially derived from cardiac myocytes, may be induced by Ang II via the AT1 and AT2 receptors. Additionally, amelioration of PO-induced cardiac hypertrophy following losartan treatment may be associated with the reduction of HMGB1 expression through the AT1 receptor.
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Affiliation(s)
- Lei Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Baoli Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Ying Yu
- Department of General Practice, Zhongshan Hospital, Fudan University
| | - Jingfeng Wang
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Jian Wu
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Yangang Su
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Hong Jiang
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Yunzeng Zou
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University.,Shanghai Institute of Cardiovascular Diseases
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12
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Lewandowski AJ, Levy PT, Bates ML, McNamara PJ, Nuyt AM, Goss KN. Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk. Hypertension 2020; 76:1028-1037. [PMID: 32816574 PMCID: PMC7480939 DOI: 10.1161/hypertensionaha.120.15574] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Preterm birth accounts for over 15 million global births per year. Perinatal interventions introduced since the early 1980s, such as antenatal glucocorticoids, surfactant, and invasive ventilation strategies, have dramatically improved survival of even the smallest, most vulnerable neonates. As a result, a new generation of preterm-born individuals has now reached early adulthood, and they are at increased risk of cardiovascular diseases. To better understand the sequelae of preterm birth, cardiovascular follow-up studies in adolescents and young adults born preterm have focused on characterizing changes in cardiac, vascular, and pulmonary structure and function. Being born preterm associates with a reduced cardiac reserve and smaller left and right ventricular volumes, as well as decreased vascularity, increased vascular stiffness, and higher pressure of both the pulmonary and systemic vasculature. The purpose of this review is to present major epidemiological evidence linking preterm birth with cardiovascular disease; to discuss findings from clinical studies showing a long-term impact of preterm birth on cardiac remodeling, as well as the systemic and pulmonary vascular systems; to discuss differences across gestational ages; and to consider possible driving mechanisms and therapeutic approaches for reducing cardiovascular burden in individuals born preterm.
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Affiliation(s)
- Adam J Lewandowski
- From the Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (A.J.L.)
| | - Philip T Levy
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Harvard University, MA (P.T.L.)
| | - Melissa L Bates
- Department of Health and Human Physiology (M.L.B.), University of Iowa.,Division of Neonatology (M.L.B., P.J.M.), University of Iowa
| | - Patrick J McNamara
- Division of Neonatology (M.L.B., P.J.M.), University of Iowa.,Division of Cardiology (P.J.M.), University of Iowa
| | - Anne Monique Nuyt
- Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine, Faculty of Medicine, Université de Montréal, QC, Canada (A.M.N.)
| | - Kara N Goss
- Departments of Pediatrics (K.N.G.), School of Medicine and Public Health, University of Wisconsin-Madison.,Medicine (K.N.G.), School of Medicine and Public Health, University of Wisconsin-Madison
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13
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Flahault A, Girard-Bock C, Fernandes RO, Cloutier A, Pastore YD, Luu TM, Nuyt AM. Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm. Thorax 2020; 75:494-502. [PMID: 32217779 DOI: 10.1136/thoraxjnl-2019-214307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Although erythropoiesis is impaired and anaemia frequent in neonates born preterm, haematopoiesis in adults born preterm has not been previously studied. OBJECTIVE We, thus, aimed to evaluate haemoglobin and erythropoietin levels in young adults born preterm, to identify neonatal events associated with erythropoiesis in adulthood and to examine the relationships of haemoglobin levels with respiratory function and blood pressure. METHODS We assessed a cohort of 101 young adults (ages 18-29) born preterm (≤29 weeks of gestation), in comparison to 105 full-term controls. We measured haemoglobin, erythropoietin levels and blood pressure. We also assessed respiratory function using spirometry. RESULTS Compared with controls, tobacco use and sex-adjusted haemoglobin levels were 5.3 (95% CI 2.9 to 7.7) g/L higher in preterm-born individuals, but erythropoietin levels were similar. Duration of oxygen supplementation in the neonatal period was independently associated with higher haemoglobin levels in the preterm group. In young adults born preterm with bronchopulmonary dysplasia, airflow limitation was associated with higher haemoglobin levels. Both systolic (SBP) and diastolic (DBP) blood pressure were increased in individuals born preterm (p=0.042 and p=0.0008, respectively). Higher haemoglobin levels were associated with higher SBP and DBP, independently of term or preterm status. Mediation analysis suggests that haemoglobin increase contributes to 37% and 32% of the effect of preterm birth on SBP and DBP, respectively. CONCLUSIONS Haemoglobin levels are higher in young adults born preterm, while erythropoietin levels are similar, especially in case of bronchopulmonary dysplasia and airflow limitation, and haemoglobin increase is associated with elevated blood pressure in this population.
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Affiliation(s)
- Adrien Flahault
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Camille Girard-Bock
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Rafael Oliveira Fernandes
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Anik Cloutier
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Yves D Pastore
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada.,Division of Hematology and Oncology, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
| | - Thuy Mai Luu
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada.,Division of General Pediatrics, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada .,Division of Neonatology, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
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14
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D’Ascenzi F, Sciaccaluga C, Cameli M, Cecere A, Ciccone MM, Di Francesco S, Ganau A, Imbalzano E, Liga R, Palermo P, Palmiero P, Parati G, Pedrinelli R, Scicchitano P, Zito A, Mattioli AV. When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention. Eur J Prev Cardiol 2019; 28:361-369. [PMID: 33611390 DOI: 10.1177/2047487319893832] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022]
Abstract
Abstract
Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease.
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Affiliation(s)
- Flavio D’Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
- Department of Medicine, University of Pittsburgh, USA
| | - Carlotta Sciaccaluga
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Annagrazia Cecere
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Marco M Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D’Annunzio University of Chieti-Pescara, Italy
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, Italy
| | - Antonello Ganau
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Riccardo Liga
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy
| | | | | | - Gianfranco Parati
- Department of Cardiovascular, Neural, and Metabolic Sciences, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Italy
- School of Medicine and Surgery, University Milano-Bicocca, Italy
| | - Roberto Pedrinelli
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy
| | - Piero Scicchitano
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Annapaola Zito
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
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15
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Mian MOR, He Y, Bertagnolli M, Mai-Vo TA, Fernandes RO, Boudreau F, Cloutier A, Luu TM, Nuyt AM. TLR (Toll-Like Receptor) 4 Antagonism Prevents Left Ventricular Hypertrophy and Dysfunction Caused by Neonatal Hyperoxia Exposure in Rats. Hypertension 2019; 74:843-853. [PMID: 31476902 DOI: 10.1161/hypertensionaha.119.13022] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Preterm birth is associated with proinflammatory conditions and alterations in adult cardiac shape and function. Neonatal exposure to high oxygen, a rat model of prematurity-related conditions, leads to cardiac remodeling, fibrosis, and dysfunction. TLR (Toll-like receptor) 4 signaling is a critical link between oxidative stress, inflammation, and the pathogenesis of cardiovascular diseases. The current study sought to investigate the role of TLR4 signaling in neonatal oxygen-induced cardiomyopathy. Male Sprague-Dawley pups were kept in 80% oxygen or room air from day 3 to 10 of life and treated with TLR4 antagonist lipopolysaccharide from the photosynthetic bacterium Rhodobacter sphaeroides(LPS-RS) or saline. Echocardiography was performed at 4, 7, and 12 weeks. At 12 weeks, intraarterial blood pressure was measured before euthanization for histological and biochemical analyses. At day 10, cardiac TLR4, Il (interleukin) 18, and Il1β expression were increased in oxygen-exposed compared with room air controls. At 4 weeks, compared with room air-saline, saline-, but not LPS-RS treated-, oxygen-exposed animals, exhibited increased left ventricle mass index, reduced ejection fraction, and cardiac output index. Findings were similar at 7 and 12 weeks. LPS-RS did not influence echocardiography in 12 weeks room air animals. Systolic blood pressure was higher in saline- but not LPS-RS treated-oxygen-exposed animals compared with room air-saline and -LPS-RS controls. LPS-RS prevented cardiac fibrosis and cardiomyocytes hypertrophy, the increased TLR4, Myd88, and Il18 gene expression, TRIF expression, and CD68+ macrophages infiltration associated with neonatal oxygen exposure, without impact in room air rats. This study indicates that neonatal exposure to high oxygen programs TLR4 activation, which contributes to cardiac remodeling and dysfunction.
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Affiliation(s)
- Muhammad Oneeb Rehman Mian
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Ying He
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Mariane Bertagnolli
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Thuy-An Mai-Vo
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Rafael Oliveira Fernandes
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Fauve Boudreau
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Anik Cloutier
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Thuy Mai Luu
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
| | - Anne Monique Nuyt
- From the Department of Pediatrics, Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, QC, Canada
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16
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Poletto Bonetto JH, Fernandes RO, Dartora DR, Flahault A, Sonea A, He Y, Cloutier A, Belló-Klein A, Nuyt AM. Impact of early life AT 1 blockade on adult cardiac morpho-functional changes and the renin-angiotensin system in a model of neonatal high oxygen-induced cardiomyopathy. Eur J Pharmacol 2019; 860:172585. [PMID: 31376367 DOI: 10.1016/j.ejphar.2019.172585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/23/2019] [Accepted: 07/31/2019] [Indexed: 11/18/2022]
Abstract
We previously reported that neonatal blockade of angiotensin II AT1 receptor prevents cardiac changes in 4 weeks rats with neonatal hyperoxia-induced cardiomyopathy, a recognized model of prematurity-related deleterious conditions. Considering the importance of AT1 receptor and the renin angiotensin system (RAS) in normal development, the present study aimed to investigate the adult effects of neonatal AT1 blockade on left ventricle (LV) in rats exposed to neonatal hyperoxia. Sprague-Dawley pups were exposed to 80% O2 or room air from days 3-10. AT1 blocker (losartan) or H2O were given by gavage from day 8-10. LV function (echo and intraventricular pressure), histology and expression of RAS components were examined in 15-16 weeks old adult males. Losartan treatment prevented myocardial fibrosis, LV wall thickening and stroke volume reduction in rats exposed to high O2 in the neonatal period. However, Losartan treatment of O2-exposed pups led to reduced ejection fraction (EF) and fractional shortening (FS), and did not prevent changes in diastolic function. Losartan also did not prevent increased LV AT2 and decreased angiotensin-(1-7) Mas receptors expression observed in high O2-exposed rats. Neonatal Losartan attenuated long-term impact of neonatal hyperoxia but also led to decreased EF and FS. Increased AT2 and decreased Mas receptor expression observed in O2-exposed group were unaffected by Losartan treatment. Our results show that early life Losartan treatment aimed at preventing cardiac consequences of neonatal deleterious conditions may also comprise detrimental effects that require further investigation prior to clinical translation in developing children.
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Affiliation(s)
- Jéssica Hellen Poletto Bonetto
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada; Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Institute of Basic Health Science (ICBS), Federal University of Rio Grande do Sul (UFRGS), Rio Grande do Sul, Brazil
| | - Rafael Oliveira Fernandes
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Daniela Ravizzoni Dartora
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Adrien Flahault
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Aurélie Sonea
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Ying He
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Anik Cloutier
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Adriane Belló-Klein
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Institute of Basic Health Science (ICBS), Federal University of Rio Grande do Sul (UFRGS), Rio Grande do Sul, Brazil
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital and Research Center, Department of Pediatrics, Faculty of Medicine, Université de Montréal, Québec, Canada.
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17
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Ventricular remodeling in preterm infants: computational cardiac magnetic resonance atlasing shows significant early remodeling of the left ventricle. Pediatr Res 2019; 85:807-815. [PMID: 30758323 DOI: 10.1038/s41390-018-0171-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/01/2018] [Accepted: 08/27/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Premature birth is associated with ventricular remodeling, early heart failure, and altered left ventricular (LV) response to physiological stress. Using computational cardiac magnetic resonance (CMR) imaging, we aimed to quantify preterm ventricular remodeling in the neonatal period, and explore contributory clinical factors. METHODS Seventy-three CMR scans (34 preterm infants, 10 term controls) were performed to assess in-utero development and preterm ex-utero growth. End-diastolic computational atlases were created for both cardiac ventricles; t statistics, linear regression modeling, and principal component analysis (PCA) were used to describe the impact of prematurity and perinatal factors on ventricular volumetrics, ventricular geometry, myocardial mass, and wall thickness. RESULTS All preterm neonates demonstrated greater weight-indexed LV mass and higher weight-indexed end-diastolic volume at term-corrected age (P < 0.05 for all preterm gestations). Independent associations of increased term-corrected age LV myocardial wall thickness were (false discovery rate <0.05): degree of prematurity, antenatal glucocorticoid administration, and requirement for >48 h postnatal respiratory support. PCA of LV geometry showed statistical differences between all preterm infants at term-corrected age and term controls. CONCLUSIONS Computational CMR demonstrates that significant LV remodeling occurs soon after preterm delivery and is associated with definable clinical situations. This suggests that neonatal interventions could reduce long-term cardiac dysfunction.
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18
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Paquette K, Fernandes RO, Xie LF, Cloutier A, Fallaha C, Girard-Bock C, Mian MOR, Lukaszewski MA, Mâsse B, El-Jalbout R, Lapeyraque AL, Santos RA, Luu TM, Nuyt AM. Kidney Size, Renal Function, Ang (Angiotensin) Peptides, and Blood Pressure in Young Adults Born Preterm. Hypertension 2019; 72:918-928. [PMID: 30354721 DOI: 10.1161/hypertensionaha.118.11397] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Preterm birth incurs a higher risk for adult cardiovascular diseases, including hypertension. Because preterm birth may impact nephrogenesis, study objectives were to assess renal size and function of adults born preterm versus full term and to examine their relationship with blood pressure (BP; 24-hour ambulatory BP monitoring) and circulating renin-Ang (angiotensin) system peptides. The study included 92 young adults born (1987-1997) preterm (≤29 weeks of gestation) and term (n=92) matched for age, sex, and race. Young adults born preterm had smaller kidneys (80±17 versus 90±18 cm3/m2; P<0.001), higher urine albumin-to-creatinine ratio (0.70; interquartile range, 0.47-1.14 versus 0.58, interquartile range 0.42 to 0.78 mg/mmol, P=0.007), higher 24-hour systolic (121±9 versus 116±8 mm Hg; P=0.001) and diastolic (69±5 versus 66±6 mm Hg; P=0.004) BP, but similar estimated glomerular filtration rate. BP was inversely correlated with kidney size in preterm participants. Plasma Ang I was higher in preterm versus term participants (36.3; interquartile range, 13.2-62.3 versus 19.4; interquartile range, 9.9-28.1 pg/mL; P<0.001). There was no group difference in renin, Ang II, Ang (1-7), and alamandine. In the preterm, but not in the term group, higher BP was significantly associated with higher renin and alamandine and lower birth weight and gestational age with smaller adult kidney size. Young adults born preterm have smaller kidneys, higher urine albumin-to-creatinine ratio, higher BP, and higher circulating Ang I levels compared with term controls. Preterm young adults with smaller kidneys have higher BP. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT03261609.
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Affiliation(s)
- Katryn Paquette
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Rafael Oliveira Fernandes
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Li Feng Xie
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Anik Cloutier
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Catherine Fallaha
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Camille Girard-Bock
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Muhammad Oneeb Rehman Mian
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Marie-Amélie Lukaszewski
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Benoit Mâsse
- Department of Social and Preventive Medicine, School of Public Health (B.M.), University of Montreal, Quebec, Canada
| | - Ramy El-Jalbout
- Department of Medical Imaging, Sainte-Justine University Hospital (R.E.-J.), University of Montreal, Quebec, Canada
| | - Anne-Laure Lapeyraque
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Robson A Santos
- Department of Physiology and Biophysics, Federal University of Minas Gerais, Belo Horizonte, Brazil (R.A.S.)
| | - Thuy Mai Luu
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
| | - Anne Monique Nuyt
- From the Department of Pediatrics, Sainte-Justine University Hospital Research Center (K.P., R.O.F., L.F.X., A.C., C.F., C.G.-B., M.O.R.M., M.-A.L., A.-L.L., T.M.L., A.M.N.), University of Montreal, Quebec, Canada
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Preterm Birth Is a Novel, Independent Risk Factor for Altered Cardiac Remodeling and Early Heart Failure: Is it Time for a New Cardiomyopathy? CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2019; 21:8. [PMID: 30762137 DOI: 10.1007/s11936-019-0712-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW Around 10% of the global population is born preterm (< 37 weeks' gestation). Preterm birth is associated with an increased risk of cardiovascular events, with preterm-born individuals demonstrating a distinct cardiac phenotype. This review aims to summarize the main phenotypic features of the preterm heart and directions for future research to develop novel intervention strategies. RECENT FINDINGS Being born between 28 and 31 weeks' gestation results in a 4-fold higher risk of heart failure in childhood and adolescence and 17-fold increased risk when born less than 28 weeks' gestation. In support of this being due to a reduction in myocardial functional reserve, preterm-born young adults have an impaired left ventricular cardiac systolic response to moderate and high intensity physiological stress, despite having a preserved resting left ventricular ejection fraction. Similar impairments under physiological stress were also recently reported regarding the right ventricle in young adults born preterm. Preterm birth relates to a unique cardiac phenotype with an impaired response to stress conditions. These data, combined with the work in animal models, suggest that being born preterm may lead to a novel form of cardiomyopathy. Understanding the driving mechanisms leading to this unique cardiac phenotype is important to reduce risk of future heart failure and cardiovascular events.
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Affiliation(s)
- Adam J. Lewandowski
- 0000 0004 1936 8948grid.4991.5Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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21
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Girard‐Bock C, de Araújo CC, Bertagnolli M, Mai‐Vo T, Vadivel A, Alphonse RS, Zhong S, Cloutier A, Sutherland MR, Thébaud B, Nuyt AM. Endothelial colony-forming cell therapy for heart morphological changes after neonatal high oxygen exposure in rats, a model of complications of prematurity. Physiol Rep 2018; 6:e13922. [PMID: 30485704 PMCID: PMC6260919 DOI: 10.14814/phy2.13922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 10/21/2018] [Indexed: 12/28/2022] Open
Abstract
Very preterm birth is associated with increased cardiovascular diseases and changes in myocardial structure. The current study aimed to investigate the impact of endothelial colony-forming cell (ECFC) treatment on heart morphological changes in the experimental model of neonatal high oxygen (O2 )-induced cardiomyopathy, mimicking prematurity-related conditions. Sprague-Dawley rat pups exposed to 95% O2 or room air (RA) from day 4 (P4) to day 14 (P14) were randomized to receive (jugular vein) exogenous human cord blood ECFC or vehicle at P14 (n = 5 RA-vehicle, n = 8 RA-ECFC, n = 8 O2 -vehicle and n = 7 O2 -ECFC) and the hearts collected at P28. Body and heart weights and heart to body weight ratio did not differ between groups. ECFC treatment prevented the increase in cardiomyocyte surface area in both the left (LV) and right (RV) ventricles of the O2 group (O2 -ECFC vs. O2 -vehicle LV: 121 ± 13 vs. 179 ± 21 μm2 , RV: 118 ± 12 vs. 169 ± 21 μm2 ). In O2 rats, ECFC treatment was also associated with a significant reduction in interstitial fibrosis in both ventricles (O2 -ECFC vs. O2 -vehicle LV: 1.07 ± 0.47 vs. 1.68 ± 0.41% of surface area, RV: 1.01 ± 0.74 vs. 1.77 ± 0.67%) and in perivascular fibrosis in the LV (2.29 ± 0.47 vs. 3.85 ± 1.23%) but in not the RV (1.95 ± 0.95 vs. 2.74 ± 1.14), and with increased expression of angiogenesis marker CD31. ECFC treatment had no effect on cardiomyocyte surface area or on tissue fibrosis of RA rats. Human cord blood ECFC treatment prevented cardiomyocyte hypertrophy and myocardial and perivascular fibrosis observed after neonatal high O2 exposure. ECFC could constitute a new regenerative therapy against cardiac sequelae caused by deleterious conditions of prematurity.
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Affiliation(s)
- Camille Girard‐Bock
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
| | - Carla C. de Araújo
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
| | - Mariane Bertagnolli
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
- Present address:
Centre Intégré Universitaire de Santé et de Services Sociaux du Nord‐de‐l’Île‐de‐MontréalHôpital du Sacré‐Cœur de Montréal Research CenterUniversité de MontréalMontréalQuebecCanada
| | - Thuy‐An Mai‐Vo
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
| | - Arul Vadivel
- Ottawa Hospital Research InstituteUniversity of OttawaOttawaOntarioCanada
| | | | - Shumei Zhong
- Ottawa Hospital Research InstituteUniversity of OttawaOttawaOntarioCanada
| | - Anik Cloutier
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
| | - Megan R. Sutherland
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
- Present address:
Monash Biomedicine Discovery InstituteDepartment of Anatomy and Developmental BiologyMonash UniversityClaytonVictoriaAustralia
| | - Bernard Thébaud
- Ottawa Hospital Research InstituteUniversity of OttawaOttawaOntarioCanada
- Department of PediatricsUniversity of AlbertaEdmontonAlbertaCanada
| | - Anne Monique Nuyt
- Department of PediatricsSainte‐Justine University Hospital Research CenterFaculty of MedicineUniversité de MontréalMontrealQuebecCanada
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22
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Bertagnolli M, Xie LF, Paquette K, He Y, Cloutier A, Fernandes RO, Béland C, Sutherland MR, Delfrate J, Curnier D, Bigras JL, Rivard A, Thébaud B, Luu TM, Nuyt AM. Endothelial Colony-Forming Cells in Young Adults Born Preterm: A Novel Link Between Neonatal Complications and Adult Risks for Cardiovascular Disease. J Am Heart Assoc 2018; 7:JAHA.118.009720. [PMID: 29987124 PMCID: PMC6064846 DOI: 10.1161/jaha.118.009720] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Preterm birth is linked to cardiovascular risks and diseases. Endothelial progenitor cells play a critical role in vascular development and repair. Cord blood endothelial progenitor cells of preterm-born infants, especially endothelial colony-forming cells (ECFC), show enhanced susceptibility to prematurity-related pro-oxidant stress. Whether ECFC dysfunction is present in adulthood following preterm birth is unknown. METHODS AND RESULTS This cross-sectional observational study includes 55 preterm-born (≤29 gestational weeks) young adults (18-29 years old, 38% male) and 55 sex- and age-matched full-term controls. ECFC were isolated from peripheral blood; cell proliferative and vascular cord formation capacities were assessed in vitro. Daytime systolic blood pressure was higher, whereas glucose tolerance and body mass index were lower in preterm-born subjects. ECFC colonies grew in culture for 62% of full-term- and 58% of preterm-born participants. Preterm-born participants have formed ECFC colonies later in culture and have reduced proliferation compared with controls. Only in preterm-born individuals, we observed that the later the ECFC colony grows in culture, the worse was overall ECFC function. In addition, in preterms, elevated systolic blood pressure significantly correlated with reduced ECFC proliferation (rS=-0.463; P=0.030) and numbers of branches formed on matrigel (rS=-0.443; P=0.039). In preterm-born subjects, bronchopulmonary dysplasia was associated with impaired ECFC function, whereas exposure to antenatal steroids related to better ECFC function. CONCLUSIONS This study is the first to examine ECFC in preterm-born adults and to demonstrate ECFC dysfunction compared with full-term controls. In the preterm-born group, ECFC dysfunction was associated with bronchopulmonary dysplasia, the major prematurity-related neonatal morbidity, and with increased systolic blood pressure into adulthood.
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Affiliation(s)
- Mariane Bertagnolli
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada.,Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal Research Center, Université de Montréal, Quebec, Canada.,Department of Kinesiology, Université de Montréal, Quebec, Canada
| | - Li Feng Xie
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada
| | - Katryn Paquette
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada.,Division of Neonatology, Department of Pediatrics, Sainte-Justine University Hospital Université de Montréal, Quebec, Canada
| | - Ying He
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada
| | - Anik Cloutier
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada
| | | | - Chanel Béland
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada
| | - Megan R Sutherland
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada
| | - Jacques Delfrate
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada.,Department of Kinesiology, Université de Montréal, Quebec, Canada
| | - Daniel Curnier
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada.,Department of Kinesiology, Université de Montréal, Quebec, Canada
| | - Jean-Luc Bigras
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada.,Division of Cardiology, Department of Pediatrics, Sainte-Justine University Hospital Université de Montréal, Quebec, Canada
| | - Alain Rivard
- Division of Cardiology, Department of Medicine, CHUM Research Center, Montréal, Canada
| | - Bernard Thébaud
- Department of Pediatrics, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada
| | - Thuy Mai Luu
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada.,Division of General Pediatrics, Department of Pediatrics, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital Research Center, Université de Montréal, Quebec, Canada .,Division of Neonatology, Department of Pediatrics, Sainte-Justine University Hospital Université de Montréal, Quebec, Canada
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23
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Mitchell T, MacDonald JW, Srinouanpranchanh S, Bammler TK, Merillat S, Boldenow E, Coleman M, Agnew K, Baldessari A, Stencel-Baerenwald JE, Tisoncik-Go J, Green RR, Gale MJ, Rajagopal L, Adams Waldorf KM. Evidence of cardiac involvement in the fetal inflammatory response syndrome: disruption of gene networks programming cardiac development in nonhuman primates. Am J Obstet Gynecol 2018; 218:438.e1-438.e16. [PMID: 29475580 PMCID: PMC6070341 DOI: 10.1016/j.ajog.2018.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/22/2017] [Accepted: 01/04/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Most early preterm births are associated with intraamniotic infection and inflammation, which can lead to systemic inflammation in the fetus. The fetal inflammatory response syndrome describes elevations in the fetal interleukin-6 level, which is a marker for inflammation and fetal organ injury. An understanding of the effects of inflammation on fetal cardiac development may lead to insight into the fetal origins of adult cardiovascular disease. OBJECTIVE The purpose of this study was to determine whether the fetal inflammatory response syndrome is associated with disruptions in gene networks that program fetal cardiac development. STUDY DESIGN We obtained fetal cardiac tissue after necropsy from a well-described pregnant nonhuman primate model (pigtail macaque, Macaca nemestrina) of intrauterine infection (n=5) and controls (n=5). Cases with the fetal inflammatory response syndrome (fetal plasma interleukin-6 >11 pg/mL) were induced by either choriodecidual inoculation of a hypervirulent group B streptococcus strain (n=4) or intraamniotic inoculation of Escherichia coli (n=1). RNA and protein were extracted from fetal hearts and profiled by microarray and Luminex (Millipore, Billerica, MA) for cytokine analysis, respectively. Results were validated by quantitative reverse transcriptase polymerase chain reaction. Statistical and bioinformatics analyses included single gene analysis, gene set analysis, Ingenuity Pathway Analysis (Qiagen, Valencia, CA), and Wilcoxon rank sum. RESULTS Severe fetal inflammation developed in the context of intraamniotic infection and a disseminated bacterial infection in the fetus. Interleukin-6 and -8 in fetal cardiac tissues were elevated significantly in fetal inflammatory response syndrome cases vs controls (P<.05). A total of 609 probe sets were expressed differentially (>1.5-fold change, P<.05) in the fetal heart (analysis of variance). Altered expression of select genes was validated by quantitative reverse transcriptase polymerase chain reaction that included several with known functions in cardiac injury, morphogenesis, angiogenesis, and tissue remodeling (eg, angiotensin I converting enzyme 2, STEAP family member 4, natriuretic peptide A, and secreted frizzled-related protein 4; all P<.05). Multiple gene sets and pathways that are involved in cardiac morphogenesis and vasculogenesis were downregulated significantly by gene set and Ingenuity Pathway Analysis (hallmark transforming growth factor beta signaling, cellular morphogenesis during differentiation, morphology of cardiovascular system; all P<.05). CONCLUSION Disruption of gene networks for cardiac morphogenesis and vasculogenesis occurred in the preterm fetal heart of nonhuman primates with preterm labor, intraamniotic infection, and severe fetal inflammation. Inflammatory injury to the fetal heart in utero may contribute to the development of heart disease later in life. Development of preterm labor therapeutics must also target fetal inflammation to lessen organ injury and potential long-term effects on cardiac function.
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Affiliation(s)
- Timothy Mitchell
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA
| | - James W MacDonald
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | | | - Theodor K Bammler
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Sean Merillat
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA
| | - Erica Boldenow
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA
| | | | - Kathy Agnew
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA
| | - Audrey Baldessari
- Washington National Primate Research Center, University of Washington, Seattle, WA
| | - Jennifer E Stencel-Baerenwald
- Department of Immunology, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA
| | - Jennifer Tisoncik-Go
- Department of Immunology, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA
| | - Richard R Green
- Department of Immunology, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA
| | - Michael J Gale
- Department of Immunology, University of Washington, Seattle, WA; Department of Global Health, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA
| | - Lakshmi Rajagopal
- Department of Pediatrics, University of Washington, Seattle, WA; Department of Global Health, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA; Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA
| | - Kristina M Adams Waldorf
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA; Department of Global Health, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA; Sahlgrenska Academy, Gothenburg, Sweden.
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24
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Lewandowski AJ. Cardiac Remodeling in Preterm-Born Adults: Long-Term Benefits of Human Milk Consumption in Preterm Neonates. Breastfeed Med 2018; 13:S3-S4. [PMID: 29624428 DOI: 10.1089/bfm.2018.29071.ajl] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Adam J Lewandowski
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford , Oxford, United Kingdom
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25
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Huckstep OJ, Williamson W, Telles F, Burchert H, Bertagnolli M, Herdman C, Arnold L, Smillie R, Mohamed A, Boardman H, McCormick K, Neubauer S, Leeson P, Lewandowski AJ. Physiological Stress Elicits Impaired Left Ventricular Function in Preterm-Born Adults. J Am Coll Cardiol 2018; 71:1347-1356. [PMID: 29566820 PMCID: PMC5864965 DOI: 10.1016/j.jacc.2018.01.046] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Experimental and clinical studies show that prematurity leads to altered left ventricular (LV) structure and function with preserved resting LV ejection fraction (EF). Large-scale epidemiological data now links prematurity to increased early heart failure risk. OBJECTIVES The authors performed echocardiographic imaging at prescribed exercise intensities to determine whether preterm-born adults have impaired LV functional response to physical exercise. METHODS We recruited 101 normotensive young adults born preterm (n = 47; mean gestational age 32.8 ± 3.2 weeks) and term (n = 54) for detailed cardiovascular phenotyping. Full clinical resting and exercise stress echocardiograms were performed, with apical 4-chamber views collected while exercising at 40%, 60%, and 80% of peak exercise capacity, determined by maximal cardiopulmonary exercise testing. RESULTS Preterm-born individuals had greater LV mass (p = 0.015) with lower peak systolic longitudinal strain (p = 0.038) and similar EF to term-born control subjects at rest (p = 0.62). However, by 60% exercise intensity, EF was 6.7% lower in preterm subjects (71.9 ± 8.7% vs 78.6 ± 5.4%; p = 0.004) and further declined to 7.3% below the term-born group at 80% exercise intensity (69.8 ± 6.4% vs 77.1 ± 6.3%; p = 0.004). Submaximal cardiac output reserve was 56% lower in preterm-born subjects versus term-born control subjects at 40% of peak exercise capacity (729 ± 1,162 ml/min/m2 vs. 1,669 ± 937 ml/min/m2; p = 0.021). LV length and resting peak systolic longitudinal strain predicted EF increase from rest to 60% exercise intensity in the preterm group (r = 0.68, p = 0.009 and r = 0.56, p = 0.031, respectively). CONCLUSIONS Preterm-born young adults had impaired LV response to physiological stress when subjected to physical exercise, which suggested a reduced myocardial functional reserve that might help explain their increased risk of early heart failure. (Young Adult Cardiovascular Health sTudy [YACHT]; NCT02103231).
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Affiliation(s)
- Odaro J Huckstep
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Wilby Williamson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Fernando Telles
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Holger Burchert
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mariane Bertagnolli
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Charlotte Herdman
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Linda Arnold
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Robert Smillie
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Afifah Mohamed
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Henry Boardman
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Kenny McCormick
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Stefan Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
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26
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Aye CYL, Lewandowski AJ, Lamata P, Upton R, Davis E, Ohuma EO, Kenworthy Y, Boardman H, Wopperer S, Packham A, Adwani S, McCormick K, Papageorghiou AT, Leeson P. Disproportionate cardiac hypertrophy during early postnatal development in infants born preterm. Pediatr Res 2017; 82:36-46. [PMID: 28399117 PMCID: PMC5511508 DOI: 10.1038/pr.2017.96] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 03/20/2017] [Indexed: 12/26/2022]
Abstract
BackgroundAdults born very preterm have increased cardiac mass and reduced function. We investigated whether a hypertrophic phenomenon occurs in later preterm infants and when this occurs during early development.MethodsCardiac ultrasound was performed on 392 infants (33% preterm at mean gestation 34±2 weeks). Scans were performed during fetal development in 137, at birth and 3 months of postnatal age in 200, and during both fetal and postnatal development in 55. Cardiac morphology and function was quantified and computational models created to identify geometric changes.ResultsAt birth, preterm offspring had reduced cardiac mass and volume relative to body size with a more globular heart. By 3 months, ventricular shape had normalized but both left and right ventricular mass relative to body size were significantly higher than expected for postmenstrual age (left 57.8±41.9 vs. 27.3±29.4%, P<0.001; right 39.3±38.1 vs. 16.6±40.8, P=0.002). Greater changes were associated with lower gestational age at birth (left P<0.001; right P=0.001).ConclusionPreterm offspring, including those born in late gestation, have a disproportionate increase in ventricular mass from birth up to 3 months of postnatal age. These differences were not present before birth. Early postnatal development may provide a window for interventions relevant to long-term cardiovascular health.
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Affiliation(s)
- Christina Y L Aye
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Pablo Lamata
- Department of Biomedical Engineering, King’s College London, London, UK
| | - Ross Upton
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Esther Davis
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Eric O Ohuma
- Centre for Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Yvonne Kenworthy
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Henry Boardman
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Samuel Wopperer
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Alice Packham
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK
| | - Satish Adwani
- Department of Paediatrics and Neonatology, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - Kenny McCormick
- Department of Paediatrics and Neonatology, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - Aris T Papageorghiou
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, Oxfordshire, UK
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxfordshire, UK,
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Sutherland MR, Béland C, Lukaszewski MA, Cloutier A, Bertagnolli M, Nuyt AM. Age- and sex-related changes in rat renal function and pathology following neonatal hyperoxia exposure. Physiol Rep 2017; 4:4/15/e12887. [PMID: 27528005 PMCID: PMC4985552 DOI: 10.14814/phy2.12887] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 07/18/2016] [Indexed: 12/04/2022] Open
Abstract
Preterm neonates are prematurely exposed to high oxygen levels at birth which may adversely impact ongoing renal development. The aim of this study was to determine the effects of neonatal hyperoxia exposure on renal function and morphology with aging. Sprague Dawley rat pups were raised in a hyperoxic environment (80% oxygen) from P3 to P10 during ongoing postnatal nephrogenesis. Control litters were kept in room air (n = 6–8 litters/group; one male, one female/litter/age). Kidney function (urine and plasma creatinine, sodium, and protein) and morphology (renal corpuscle size, glomerulosclerosis, fibrosis, and glomerular crescents) were assessed at 1, 5, and 11 months of age. Neonatal hyperoxia exposure had no impact on body or kidney weights. Creatinine clearance was significantly reduced following hyperoxia exposure at 5 months; there was no significant effect on renal function at 1 or 11 months. The percentage of crescentic glomeruli (indicative of glomerular injury) was markedly increased in 11 month hyperoxia‐exposed males. Renal corpuscle size, glomerulosclerosis index, and renal fibrosis were not affected. Findings suggest that exposure to high oxygen levels during development may impact renal functional capacity and increase susceptibility to renal disease in adulthood depending on age and sex.
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Affiliation(s)
- Megan R Sutherland
- Sainte-Justine University Hospital and Research Center, Montreal, Quebec, Canada Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Chanel Béland
- Sainte-Justine University Hospital and Research Center, Montreal, Quebec, Canada Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Amélie Lukaszewski
- Sainte-Justine University Hospital and Research Center, Montreal, Quebec, Canada Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Anik Cloutier
- Sainte-Justine University Hospital and Research Center, Montreal, Quebec, Canada Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Mariane Bertagnolli
- Sainte-Justine University Hospital and Research Center, Montreal, Quebec, Canada Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital and Research Center, Montreal, Quebec, Canada Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
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