Proportionality at birth and left ventricular hypertrophy in healthy adolescents

Alexandra A. Sawyer, Norman K. Pollock, Bernard Gutin, Neal Lee Weintraub, Brian Kevin Stansfield

Research output: Contribution to journalArticle

Abstract

Background: Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy. Aims: To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length 2 and Ponderal index (PI); weight/length 3 ) at birth on one hand, with left ventricular (LV) structure and function during adolescence. Subjects: 379 healthy adolescents aged 14–18 years in Augusta, Georgia. Outcome measures: LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography. Results: When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (P quadratic = 0.04) was identified. Conclusions: Our adolescent data suggest that proportionality at birth may identify associations between perinatal growth and cardiac remodeling independent of birthweight alone.

Original languageEnglish (US)
Pages (from-to)24-29
Number of pages6
JournalEarly Human Development
Volume132
DOIs
StatePublished - May 1 2019

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Diastole
Left Ventricular Hypertrophy
Parturition
Left Ventricular Function
Weights and Measures
Body Mass Index
Systole
Low Birth Weight Infant
Financial Management
Growth
Fetal Development
Cardiac Myocytes
Social Class
Hypertrophy
Echocardiography
Linear Models
Healthy Volunteers
Outcome Assessment (Health Care)
Exercise
Mortality

Keywords

  • Birth size
  • Birth weight
  • Body mass index
  • Cardiac development
  • Heart failure
  • Intrauterine growth restriction
  • Left ventricular hypertrophy
  • Ponderal index

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Proportionality at birth and left ventricular hypertrophy in healthy adolescents. / Sawyer, Alexandra A.; Pollock, Norman K.; Gutin, Bernard; Weintraub, Neal Lee; Stansfield, Brian Kevin.

In: Early Human Development, Vol. 132, 01.05.2019, p. 24-29.

Research output: Contribution to journalArticle

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AB - Background: Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy. Aims: To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length 2 and Ponderal index (PI); weight/length 3 ) at birth on one hand, with left ventricular (LV) structure and function during adolescence. Subjects: 379 healthy adolescents aged 14–18 years in Augusta, Georgia. Outcome measures: LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography. Results: When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (P quadratic = 0.04) was identified. Conclusions: Our adolescent data suggest that proportionality at birth may identify associations between perinatal growth and cardiac remodeling independent of birthweight alone.

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KW - Heart failure

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KW - Left ventricular hypertrophy

KW - Ponderal index

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