Reduced brachial flow-mediated vasodilation in young adult ex extremely low birth weight preterm: a condition predictive of increased cardiovascular risk?

Background.Sporadic data present in literature report how preterm birth and low birth weight constitute the risk factors for the development of cardiovascular diseases in later life. Aim.To assess the presence of potential alterations to endothelial function in young adults born preterm at extremely low birth weight (<1000g; ex ELBW). Method.Thirty-two ex-ELBW subjects (10 males [M] and 22 females [F], aged 17-28 years, mean [±DS] 20.1±2.5 years) were compared with 32 healthy, age-matched subjects born at term (C, 9 M and 23 F). Exclusion criteria: 1) pathological conditions known to affect endothelial function; 2) administration of drugs known to affect endothelial function. Endothelial function was assessed by non-invasive finger plethysmography, previously validated by the US Food and Drug Administration (Endopath; Itamar Medical Ltd., Cesarea, Israel). Results.Endothelial function was significantly reduced in ex-ELBW subjects compared to C (1.94±0.37 vs 2.68±0.41, p<0.0001). Moreover, this function correlated significantly with gestational age (r=0.56, p<0.0009) and birth weight (r=0.63, p<0.0001). Conclusions.The results obtained reveal a significant decrease in endothelial function of ex-ELBW subjects compared to controls, underlining a probable correlation with preterm birth and low birth weight. Taken together, these results suggest that an ELBW may underlie the onset of early circulatory dysfunction predictive of increased cardiovascular risk.