The purpose of the CHAPTER study is to help understand how complications during pregnancy, such as preterm birth, affect how childrens' hearts and blood vessels develop.
Young adults born preterm (less than 37 weeks gestation) have alterations in the structure and function of the heart, with similar changes observed in preterm infants in the first three months of life. It is unknown whether these early changes in the heart seen in the first few months of life are relevant to long-term changes in heart structure and function. Heart changes have also not been well studied in children born preterm. To investigate this, the study will follow up children from the EPOCH study and will perform two study visits for each child (n=100 preterm and n=100 term) that will use echocardiography and cardiovascular magnetic resonance. Individuals in the EPOCH study had echocardiography measures done at birth and three months postnatal age. It will therefore be possible to do longitudinal echocardiography measures from birth up to ages 12 years to determine whether postnatal heart changes in preterm infants track into childhood. Cardiovascular magnetic resonance will allow for the determination of whether these early heart changes influence heart pump function. Finally, by measuring lung function, blood vessel structure and function, and blood pressure, it will be possible to determine how heart changes relate to other components of the cardiovascular system. This data will be used to confirm the relevance of early heart remodelling in preterm-born offspring over time and provide more comprehensive heart phenotyping for preterm-born children. Together, this information can be used to design future intervention strategies in preterm-born individuals to reduce cardiovascular risk in this growing subgroup of the population.
Study Type
OBSERVATIONAL
Enrollment
200
University of Oxford
Oxford, United Kingdom
Cardiac left ventricular mass
Echocardiography assessment of left ventricular mass indexed to body surface area (in g and g/m\^2)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac right ventricular mass
Echocardiography assessment of right ventricular mass indexed to body surface area (in g and g/m\^2)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac left ventricular end-diastolic volume
Echocardiography assessment of cardiac left ventricular end-diastolic volume indexed to body surface area (in ml and ml/m\^2)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac right ventricular end-diastolic volume
Echocardiography assessment of cardiac right ventricular end-diastolic volume indexed to body surface area (in ml and ml/m\^2)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac left ventricular systolic function
Echocardiography assessment of left ventricular systolic function: left ventricular ejection fraction (in %)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac right ventricular systolic function
Echocardiography assessment of right ventricular systolic function: tricuspid annular plane systolic excursion (in cm)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac left ventricular diastolic function
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Echocardiography assessment of right ventricular (RV) diastolic function: RV Doppler early/late diastolic tricuspid inflow velocity ratio (E/A)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Cardiac right ventricular diastolic function
Echocardiography assessment of left ventricular (LV) diastolic function: LV Doppler early/late diastolic mitral inflow
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Morphology of the left ventricles
MRI assessment of the left ventricles morphology using cardiac statistical atlas and principal component analysis
Time frame: 6-9 years of age
Morphology of the right ventricles
MRI assessment of the right ventricles morphology using cardiac statistical atlas and principal component analysis
Time frame: 6-9 years of age
Cardiac flow dynamics of the left ventricle
MRI assessment of direct flow, delayed ejection flow, retained inflow, residual volume kinetic energy flow components at end diastole (measured at end diastole in mJ and overall % contribution)
Time frame: 6-9 years of age
Systolic blood pressure measurement
Resting brachial blood pressure measurement (in mmHg)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Diastolic blood pressure measurement
Resting brachial blood pressure measurement (in mmHg)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Mean arterial pressure
The average arterial pressure from resting brachial blood pressure measurement (in mmHg)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Retinal arteriolar structure
Central retinal arteriolar equivalent (CRAE in μm) measured using retinal imaging
Time frame: 6-9 years of age
Retinal venular structure
Central retinal venular equivalent (CRVE in μm) measured using retinal imaging
Time frame: 6-9 years of age
Retinal arteriolar-to-venular diameter ratio (AVR)
The ratio of average retinal arteriolar diameter (CRAE in μm) and average retinal venous diameter (CRVE in μm) measured using retinal imaging
Time frame: 6-9 years of age
Lung function
The forced expiratory volume in one second (FEV1 in L), forced vital capacity (FVC in L), and the ratio of FEV1 to FVC (FEV1/FVC) measured using spirometry
Time frame: 6-9 years of age
Objective measure of physical activity
The amount of moderate to vigorous physical activity (in h/week) and vigorous physical activity (in h/week) measured using wrist worn accelerometer
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Body weight
Body weight measured in kg
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Body height
Body weight measured in m
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Body mass index
Body weight divided by the square of height (in kg/m2)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Mid-arm circumference
Mid-arm circumference measured in cm
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age
Waist-to-hip ratio
The ratio of waist circumference (in cm) to hip circumference (in cm)
Time frame: 3-5 years of age OR 8-12 years of age; AND 6-9 years of age