Association of Bronchopulmonary Dysplasia and Right Ventricular Systolic Function in Young Adults Born Preterm

Abstract

Adults born preterm are at a higher risk of cardiopulmonary disease and of premature death. Preterm birth is associated with abnormalities in RV structure and function, but the impact of bronchopulmonary dysplasia (BPD), a common complication of extremely preterm birth, on these parameters remains unknown. Are preterm birth and BPD associated with alterations in RV structure and function in early adulthood? and Methods: We obtained echocardiographic and spirometry data from the Health of Adults born Preterm Investigation. We evaluated RV structure and performance using echocardiography, and respiratory function using spirometry. Study comprised 86 young adults born preterm before 30 weeks of gestation, including 28 with moderate to severe BPD, and 85 adults of the same age born full term. Individuals were assessed at a mean age of 23 years. RV systolic function was altered in the preterm group, with lower tricuspid annular plane systolic excursion (TAPSE), lower RVs' and RV outflow tract velocity-time integral values, especially in those born preterm with BPD. Nine (36%) participants born preterm with BPD, 6 (13%) participants born preterm without BPD and 6 (8%) participants born full-term had a TAPSE value below 16 mm, a marker of RV systolic dysfunction (P-value for the comparison between preterm no BPD and BPD, 0.032). We found no difference in RV diastolic function and estimates of pulmonary artery pressure between groups. Although respiratory function was altered in those born preterm, and more so in the case of BPD, we observed no association between spirometry indices of respiratory function and RV systolic function. Preterm birth is associated in adulthood with alterations in RV systolic function, which are more pronounced in the case of BPD.