Fetal and infant growth patterns and left and right ventricular measures in childhood assessed by cardiac MRI

Liza Toemen,Willem A Helbing,Arno A Roest,Romy Gaillard,Eric Ap Steegers,Vincent Wv Jaddoe,Aad Van Der Lugt,Rob J Van Der Geest

doi:10.1177/2047487319866022

Abstract

Early life is critical for cardiac development. We examined the associations of longitudinal fetal and childhood growth patterns with childhood right and left ventricular structures measured by cardiac magnetic resonance imaging. In a population-based prospective cohort study among 2827 children, we measured growth at 20 and 30 weeks of pregnancy, at birth, 0.5, 1, 2, 6 and 10 years. At 10 years, we measured right ventricular end-diastolic volume, left ventricular end-diastolic volume, left ventricular mass and left ventricular mass-to-volume ratio by cardiac magnetic resonance imaging. Small size for gestational age at birth was associated with smaller right and left ventricular end-diastolic volume relative to current body surface area, but with larger left ventricular mass-to-volume ratio (P < 0.05). Children in the upper 25% of right and left ventricular end-diastolic volume and left ventricular mass at age 10 years were larger at birth and became taller and leaner in childhood (P < 0.05). In contrast, children in the lower 25% of right and left ventricular end-diastolic volume and left ventricular mass were smaller at birth and became shorter and heavier in childhood (P < 0.05). Both fetal and childhood growth were independently of each other associated with childhood right and left ventricular end-diastolic volume and left ventricular mass. Children who are larger at birth and grow taller and leaner in childhood have larger hearts relative to body surface area. Small size at birth children, who grow shorter and heavier in childhood, have relatively smaller hearts with larger left ventricular mass-to-volume ratio. Both fetal and childhood growth are important for the development of cardiac dimensions.

Highlights

Fetal exposure to an adverse environment leads to cardiovascular adaptations, which predispose individuals to disease in later life.[1,2] Evidence suggests that earlylife growth patterns directly affect cardiac structure and up studies have shown that individuals with a lower weight in infancy have a higher left ventricular mass (LVM) in adulthood, an independent risk factor for mortality.[3]
A 1 standard deviation scores (SDS) higher birth weight was associated with higher right ventricular end-diastolic volume (RVEDV) (0.09 SDS, 95% CI 0.06, 0.13) and left ventricular end-diastolic volume (LVEDV) (0.10 SDS, 95% CI 0.06, 0.13), relative to current body size
Birth weight adjusted for gestational age was associated with lower left ventricular mass-to-volume ratio (LMVR) (–0.06 SDS, 95% CI –0.10, –0.02)

Summary

Introduction

Fetal exposure to an adverse environment leads to cardiovascular adaptations, which predispose individuals to disease in later life.[1,2] Evidence suggests that earlylife growth patterns directly affect cardiac structure and up studies have shown that individuals with a lower weight in infancy have a higher left ventricular mass (LVM) in adulthood, an independent risk factor for mortality.[3]. These previous studies strongly suggest that early life is important for the programming of cardiac structure, function and disease in later life, it remains unknown which period in fetal life or infancy is critical

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