Young Adult Cardiovascular Health sTudy

Study Overview
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Brief Summary
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The purpose of this study is to understand more about why young people who were born prematurely may have increased risk of high blood pressure and lower cardiovascular exercise capacity.

Detailed Description
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Young adults with a history of preterm birth are identified as having a unique risk profile for developing hypertension and having reduced exercise capacity. Globally, there are 15 million annual preterm births. In Europe, incidence is 6-15% of all births, with up to 6 million adults in the United Kingdom having a preterm birth history. Understanding the associations between early life exposures and this early cardiovascular risk is extremely important to be able to target primary prevention strategies. As yet there are no clear explanations for the reduced exercise capacity and elevated risk of hypertension reported in preterm born young adults. Magnetic resonance imaging studies of young adult born premature demonstrated altered heart shape, with increased left ventricular mass, reduced cavity sizes and reduced stroke volumes. The changes in cardiac size identified from these studies is similar to those seen in other disease groups and has been equated to greater than 50% increased risk of cardiovascular clinical events in these groups. These structural changes may account for the reduced exercise capacity observed in preterm born young adults This study aims to understand the physiological determinants of limited exercise capacity and associated cardiovascular risk profile of adult preterm born populations.

Official Title
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Young Adult Cardiovascular Health sTudy

Conditions
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Preterm Birth, Hypertension

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participant is willing and able to give informed consent for participation in the study. Male or Female, aged 18 to 40 years. History of preterm birth, diagnosis of hypertension or full term birth normotensive control Able (in the investigator's opinion) and willing to comply with all study requirements. Participant is freely able to access John Radcliffe Hospital for study visits Exclusion Criteria: Aged <18 years >40 years Unwilling or unable to give informed consent for participation in the study. Pregnant or lactating during the course of the study. Planning to donate blood during the study duration. Any significant disease or disorder which, in the opinion of the investigator, might influence the participant's ability to participate in the study. Contraindication to Magnetic Resonance Imaging

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Full Term Birth<br>History of full term birth (>37 weeks gestation) including sub-group with diagnosis of hypertension | |
| Preterm Birth<br>History of preterm birth (<37 weeks gestation) including subgroup with diagnosis of hypertension | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiopulmonary Exercise Capacity | Peak oxygen uptake measured via cardiopulmonary exercise testing | Single measure, baseline study recruitment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiac Structure | Cardiac structure measured via cardiac magnetic resonance imaging | Single measure, baseline recruitment | 
| Cardiac Function | Cardiac function measured via cardiac magnetic resonance imaging | Single measure, baseline recruitment | 
| Liver Structure | Hepatic structure measured via magnetic resonance imaging | Single measure, baseline recruitment | 
| Brain structure | Brain structure measured via magnetic resonance imaging | Second study visit within 6 months of recruitment | 
| Vascular function | Vascular function measured via pulse wave velocity | Single measure, baseline recruitment | 
| Dynamic cardiac function | Dynamic cardiac function measured using echocardiogram during exercise | Single measure, baseline recruitment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Preterm birth, Hypertension, Exercise capacity, Cardiovascular risk