Exercise Intervention to Rescue the Adverse Effect of Preterm Birth on Cardiovascular and Pulmonary Health.
Condition: Prematurity; Extreme
MeSH terms: Premature Birth
Study type: Interventional

Summary: 
      In spite of advances in neonatal intensive care allowing the first generation survivors of
      extreme prematurity to now reach young adulthood, these individuals present with reduced
      exercise capacity; a strong predictor of later chronic disease and mortality. The reason why
      individuals born preterm have exercise limitation remains unclear and may be a consequence of
      impact of preterm birth and associated neonatal difficulties on the development of organs
      important for exercise, namely the lungs, the heart, the vessels (which bring blood and
      oxygen to the muscles) and the muscles. It is well known that exercise benefits overall
      health in at-risk as well diseased populations. However, whether exercise training can
      improve fitness in young adults born preterm was not demonstrated and whether the
      cardiovascular, pulmonary and muscle impairments associated with preterm birth are reversible
      through exercise intervention in young adulthood is unknown.
    

Detailed description: 
      The investigators postulate that a 14-week exercise intervention will improve exercise
      capacity in preterm adults, as seen in other at-risk populations, in correlation with
      measures of vascular health, heart and muscle perfusion and oxygenation, and pulmonary
      function detected by cutting edge and highly sensitive imaging and circulating biomarkers.
      These markers are more sensitive to pre-disease changes than traditional health measures, and
      are largely unexplored in preterm populations.

      The investigators will:

        1. Determine whether a 14-week supervised exercise training improves exercise capacity in
           young adults (18-29 years old) born very preterm at <29 weeks gestational age.

        2. Examine whether improvement in exercise capacity is associated with changes in (a)
           markers of vascular health including circulating endothelial progenitor cells and
           microparticles, (b) cardiac perfusion by cutting-edge oxygenation-sensitive
           cardiovascular magnetic resonance imaging (MRI), (c) lung regional ventilation measured
           by newly developed hydrogen proton (1H) MRI, (d) muscle oxygenation during exercise.

        3. Compare the response of the above measures to exercise intervention between young adults
           born very preterm and term controls.
    

Intervention name(s): Exercise Intervention
Intervention type(s): Other
Intervention description(s): Assigned intervention : 14-week supervised intervention of aerobic and resistance training.
Intervention model: Single Group Assignment
Intervention model description: Group assignments. Both groups are evaluated before and after a 14 week supervised exercise (aerobic and resistance training) intervention.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: extremely preterm; young adults; term; exercise capacity; pulmonary function; muscle oxygenation