Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age Infants　– Implications for Fetal Programming –

Yohei Akazawa; Akira Hachiya; Shoko Yamazaki; Yoichiro Kawasaki; Chizuko Nakamura; Yusuke Takeuchi; Mai Kusakari; Yukihide Miyosawa; Motoko Kamiya; Noriko Motoki; Kenichi Koike; Tomohiko Nakamura

doi:10.1253/circj.CJ-16-0352

Pediatric Cardiology and Adult Congenital Heart Disease

Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age Infants　– Implications for Fetal Programming –

Yohei Akazawa, Akira Hachiya, Shoko Yamazaki, Yoichiro Kawasaki, Chizuko Nakamura, Yusuke Takeuchi, Mai Kusakari, Yukihide Miyosawa, Motoko Kamiya, Noriko Motoki, Kenichi Koike, Tomohiko Nakamura

Author information

Yohei Akazawa
Department of Pediatrics, Shinshu University School of Medicine
Akira Hachiya
Department of Pediatrics, Shinshu University School of Medicine
Shoko Yamazaki
Department of Pediatrics, Shinshu University School of Medicine
Yoichiro Kawasaki
Department of Pediatrics, Shinshu University School of Medicine
Chizuko Nakamura
Department of Pediatrics, Shinshu University School of Medicine
Yusuke Takeuchi
Department of Pediatrics, Shinshu University School of Medicine
Mai Kusakari
Department of Pediatrics, Shinshu University School of Medicine
Yukihide Miyosawa
Department of Pediatrics, Shinshu University School of Medicine
Motoko Kamiya
Department of Pediatrics, Shinshu University School of Medicine
Noriko Motoki
Department of Pediatrics, Shinshu University School of Medicine
Kenichi Koike
Department of Pediatrics, Shinshu University School of Medicine
Tomohiko Nakamura
Division of Neonatology, Department of Pediatrics, Shinshu University School of Medicine
Division of Neonatology, Nagano Children’s Hospital

Keywords: Cardiovascular disease, Intrauterine growth restriction, Remodeling, Small for gestational age

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Supplementary material

2016 Volume 80 Issue 10 Pages 2212-2220

DOI https://doi.org/10.1253/circj.CJ-16-0352

Editorial (80-10 pp. 2096-2097)

Browse “Advance online publication” version

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Abstract

Background:The purpose of this study was to clarify cardiovascular structure and function in small for gestational age (SGA) infants across a range of intrauterine growth restriction (IUGR) severity.

Methods and Results:This prospective study included 38 SGA infants and 30 appropriate for gestational age (AGA) infants. SGA infants were subclassified into severe and mild SGA according to the degree of IUGR. Cardiovascular structure and function were evaluated using echocardiography at 1 week of age. Compared with the AGA infants, both the severe and mild SGA infants showed increased left ventricular diastolic dimensions (severe SGA 10.2±2.4, mild SGA 8.2±1.3, and AGA 7.3±0.7 mm/kg, P<0.05 for all) and decreased global longitudinal strain (severe −21.1±1.6, mild −22.5±1.8, and AGA −23.8±1.8%, P<0.05 for all). Severe SGA infants showed a decreased mitral annular early diastolic velocity (severe 5.6±1.4 vs. AGA 7.0±1.3 cm/s, P<0.01) and increased isovolumic relaxation time (severe 51.3±9.2 vs. AGA 42.7±8.2 ms, P<0.01). Weight-adjusted aortic intima-media thickness and arterial wall stiffness were significantly greater in both SGA infant groups. These cardiovascular parameters tended to deteriorate with increasing IUGR severity.

Conclusions:SGA infants, including those with mild SGA, showed cardiovascular remodeling and dysfunction, which increased with IUGR severity. (Circ J 2016; 80: 2212–2220)

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