Mechanisms linking preterm birth to onset of cardiovascular disease later in adulthood

Eur Heart J. 2019 Apr 7;40(14):1107-1112. doi: 10.1093/eurheartj/ehz025.

Abstract

Cardiovascular disease (CVD) rates in adulthood are high in premature infants; unfortunately, the underlying mechanisms are not well defined. In this review, we discuss potential pathways that could lead to CVD in premature babies. Studies show intense oxidant stress and inflammation at tissue levels in these neonates. Alterations in lipid profile, foetal epigenomics, and gut microbiota in these infants may also underlie the development of CVD. Recently, probiotic bacteria, such as the mucin-degrading bacterium Akkermansia muciniphila have been shown to reduce inflammation and prevent heart disease in animal models. All this information might enable scientists and clinicians to target pathways to act early to curtail the adverse effects of prematurity on the cardiovascular system. This could lead to primary and secondary prevention of CVD and improve survival among preterm neonates later in adult life.

Keywords: Cardiovascular disease; Dyslipidaemia; Inflammation; Microbiome; Prematurity; Renin–angiotensin system.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Atherosclerosis / physiopathology
  • Cardiovascular Diseases / physiopathology*
  • Cytokines / metabolism
  • Dyslipidemias / physiopathology
  • Endothelium, Vascular / physiopathology
  • Epigenesis, Genetic / physiology
  • Gastrointestinal Microbiome / physiology
  • Humans
  • Inflammation / metabolism
  • Inflammation / physiopathology
  • Metabolic Syndrome / physiopathology
  • Nitric Oxide / metabolism
  • Oxidative Stress / physiology
  • Premature Birth / physiopathology*
  • Reactive Oxygen Species / metabolism
  • Renin-Angiotensin System / physiology

Substances

  • Cytokines
  • Reactive Oxygen Species
  • Nitric Oxide