What is the Impact of Early Life Exposures on the Cardiovascular System in Young Adulthood?

Study Overview
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Brief Summary
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The purpose of this study is to investigate whether early life exposures such as premature birth or exposure to preeclampsia before you are born results in long-term alterations in the cardiovascular system that increase risk of cardiovascular disease development.

Detailed Description
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While the incidence of cardiovascular disease has reduced dramatically, coinciding with favourable changes in risk factors, cardiovascular disease remains the single largest cause of mortality and premature mortality in the United Kingdom. Identification of novel biological pathways that underlie disease susceptibility raises the potential for new early primary prevention strategies to complement classical management. There is particular interest in the role of early environment in 'programming' risk of cardiovascular disease in later life and growing evidence that various early life exposures impact cardiovascular health in the longer term. We have thus designed the Early Vascular Study to investigate the long-term impact of early life exposures, with a particular focus on the impact of preterm birth, in the presence or absence of pregnancy-induced hypertension in the mother, on the cardiovascular system in young adulthood. This study also allows investigation of the long term impact of perinatal interventions used in this cohort. Comprehensive multi-modality non-invasive imaging measures of cardiovascular structure and function allow precise quantification of cardiovascular phenotype. This is combined with blood sample collection to study changes in molecular and metabolic markers and pathways.

Official Title
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What is the Impact of Early Life Exposures on the Cardiovascular System in Young Adulthood? A 25-Year Follow-up Study of Preterm-born Individuals

Conditions
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Preterm Birth

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. Preterm-born Cohort: Born premature (<37 weeks completed gestation), originally recruited as part of a randomised feeding trial at birth from one of five United Kingdom centres between 1982 and 1985. Term-born Cohort: Born at term (>37 weeks completed gestation) with normal birth weight for gestational age. Able (in the Investigator's opinion) and willing to comply with all study requirements. Exclusion Criteria: -The participant may not enter the study if ANY of the following apply: Unwilling or unable to give informed consent for participation in the study. 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 Cardiovascular Magnetic Resonance Imaging.

Ages Eligible for Study
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Minimum Age: 20 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 |
| --- | --- |
| Preterm-born Young Adults<br> | |
| Term-born Young Adults<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiac structure | Left ventricular mass | Young adulthood | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiac function | Global longitudinal strain and diastolic strain rate | Young adulthood | 
| Arterial stiffness | Pulse wave velocity | Young adulthood | 
| Microvascular structure | Capillary density | Young adulthood | 
| Cardiac structure | Right ventricular mass | Young Adulthood |