Abstract
Prematurity predisposes to cardiovascular disease; however the underlying mechanisms remain elusive. Disturbance of the endothelial glycocalyx (EG), an important regulator of vessel function, is thought to contribute to vascular pathology. Here, we studied the EG with respect to gestational and postnatal age in preterm and term neonates. The Perfused Boundary Region (PBR), an inverse measure of glycocalyx thickness, was measured postnatally in 85 term and 39 preterm neonates. Preterm neonates were further analyzed in two subgroups i.e., neonates born < 30 weeks gestational age (group A) and neonates born ≥ 30 weeks (group B). In preterm neonates, weekly follow-up measurements were performed if possible. PBR differed significantly between preterm and term neonates with lowest values representing largest EG dimension in extremely premature infants possibly reflecting its importance in fetal vascular development. Linear regression revealed a dependence of PBR on both, gestational age and postnatal age. Furthermore, hematocrit predicted longitudinal PBR changes. PBR measured in group A at a corrected age of > 30 weeks was significantly higher than in group B at birth, pointing towards an alteration of intrinsic maturational effects by extrinsic factors. These changes might contribute to the increased cardiovascular risk associated with extreme prematurity.
Highlights
Prematurity predisposes to cardiovascular disease; the underlying mechanisms remain elusive
The endothelial glycocalyx (EG) is a complex, highly versatile structure that has essential roles in vascular integrity and function, and destruction of the EG has been described in the pathogenesis of micro- and macrovascular d iseases[27]
The aim of the present study was to describe the state of the EG in premature and mature neonates at birth and in the postnatal period, and to look at the effects of gestational age versus postnatal age on EG dimensions
Summary
Prematurity predisposes to cardiovascular disease; the underlying mechanisms remain elusive. PBR measured in group A at a corrected age of > 30 weeks was significantly higher than in group B at birth, pointing towards an alteration of intrinsic maturational effects by extrinsic factors These changes might contribute to the increased cardiovascular risk associated with extreme prematurity. The EG has not been measured in newborns It was the aim of the present study to (1) compare the EG of mature and premature neonates at various gestational ages after birth, (2) to assess a possible association between the EG and gestational age at birth, (3) to longitudinally evaluate postnatal changes in the EG in preterm infants, (4) identify potential influencing factors by correlation of EG measurements with clinical and laboratory data
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