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The assessment of functional cardiovascular health after exercise intervention in young adults born preterm

Session Rapid Fire Abstract 4: clinical applications of cardiac function phenotyping

Speaker Elizabeth Hillier

Event : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Systolic and Diastolic Function
  • Session type : Rapid Fire Abstracts

Authors : E Hillier (Montreal,CA), S Hawkins (Montreal,CA), M G Friedrich (Montreal,CA), A M Nuyt (Montreal,CA)

E Hillier1 , S Hawkins1 , M G Friedrich1 , A M Nuyt2 , 1McGill University Health Centre - Montreal - Canada , 2Sainte- Justine University Hospital Center - Montreal - Canada ,

On behalf: MUHC CMR Group

Cardiac Magnetic Resonance: Systolic and Diastolic Function

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii242

Background: In spite of advances in neonatal care which allows the first generation of individuals born in extreme prematurity to survive, these individuals present with reduced aerobic capacity in young adulthood; a strong predictor of mortality. Clinical trials have consistently demonstrated overall cardiovascular benefits of exercise training in at-risk and diseased populations. However, whether the cardiovascular impairments associated with preterm birth are reversible through exercise intervention in young adulthood is unknown.

Purpose: This study aims to assess whether a supervised exercise intervention of aerobic and resistance training can rescue prematurity-related cardiovascular impairments as assessed by functional CMR parameters.

Methods: Eight preterm and six healthy control participants of between 18-29 years of age underwent a Cardiovascular MRI (CMR) scan (3T) both at baseline and after a 14-week duration, 3 times/week supervised exercise intervention of aerobic and resistance training. Function and structural parameters were obtained from standard short-axis SSFP cine images with full-ventricular short-axis coverage. Strain and Time to Peak strain parameters were obtained from short-axis and long-axis SSFP images. Strain response to stress measurements were obtained from SSFP cine images acquired during breathing maneuvers of a 60s period of hyperventilation.

Results: There was a significant difference in ejection fraction (p<0.05), and end-systolic volume indexed to height (LVSVi) (p<0.05) between the control and pre-term participants at baseline. All of these differences were no longer significant after the exercise intervention. There was a significant increase in myocardial mass after the intervention in both the control participants (p<0.05), and the preterm participants (p<0.05). Time to Peak Circumferential (p<0.01) and Time to Peak Longitudinal (p<0.01) strain were both decreased in control participants after exercise intervention. Additionally, controls had a significantly more pronounced Global Peak Circumferential strain response to stress when compared to pre-term participants (p<0.05). After intervention, there was no significant different in strain response between the two participant groups.

Conclusions: A supervised exercise intervention of aerobic and resistance training led to improved cardiovascular health and function in pre-term participants. The improvement in strain response to stress, EF, ESV, and LVSVi that resulted in no significant difference in parameters between pre-term and control individuals may indicate an improvement in myocardial functional response following a 13-week exercise program.

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