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Weight Gain and Blood Pressure in Toddlers Born Very Preterm.

早产儿出生的幼儿体重增加和血压。

  • 影响因子:1.65
  • DOI:10.1097/NNR.0000000000000415
  • 作者列表:"Rodriguez J","Adams-Chapman I","Affuso O","Azuero A","Downs CA","Turner-Henson A","Rice M
  • 发表时间:2020-01-13
Abstract

BACKGROUND:Preterm birth is a risk factor for elevated blood pressure in childhood and the development of hypertension and cardiometabolic disease in adulthood; however, mechanisms for the development of both are poorly understood. Rapid weight gain early in childhood may serve as a driver directly and indirectly through cortisol levels found to be elevated in early childhood in individuals born preterm. OBJECTIVES:The objective of this pilot study was to examine the effect sizes of the relationships between weight gain and blood pressure in toddlers born very preterm. A secondary aim was to note any mediating effect of cortisol on the relationships between weight gain and blood pressure. METHODS:A cross-sectional design with a convenience sample of 36 toddlers who were born very preterm was used to examine the relationships between postnatal weight gain, cortisol, and blood pressure at follow-up. RESULTS:Many of the participants experienced rapid weight gain in the first 12 months of life. Mean systolic and diastolic readings were 94 and 56.6, respectively. Diastolic blood pressure readings were obtained from 23 participants and the majority were elevated. Weight gain was associated with diastolic blood pressure with a medium effect size. A mediating role with cortisol was not supported.Although findings need to be validated in a larger sample, the blood pressure elevations in this sample were alarming. If readings continue to amplify as these children age, the fact that elevations are already present during the toddler period could indicate more significant cardiovascular disease in adulthood for this population. Rapid weight gain in early life may be a driver for elevated blood pressure even during early childhood in individuals born preterm.

摘要

背景: 早产是儿童期血压升高以及成年期高血压和心脏代谢疾病发展的危险因素; 然而,两者发展的机制知之甚少。儿童期早期体重快速增加可能直接和间接地通过在早产个体中发现幼儿期皮质醇水平升高而发挥驱动作用。 目的: 这项初步研究的目的是检查出生非常早产的幼儿体重增加和血压之间关系的影响大小。次要目的是注意皮质醇对体重增加和血压之间关系的任何中介作用。 方法: 采用横断面设计,方便抽样 36 名非常早产的幼儿,在随访时检查出生后体重增加、皮质醇和血压之间的关系。 结果: 许多参与者在出生后的前 12 个月内体重迅速增加。平均收缩压和舒张压读数分别为 94 和 56.6。从 23 名参与者获得舒张压读数,大多数人升高。体重增加与舒张压相关,效应大小中等。不支持皮质醇的中介作用。尽管研究结果需要在更大的样本中验证,但该样本中的血压升高令人担忧。如果随着这些儿童年龄的增长,读数继续放大,那么在幼儿时期已经存在升高的事实可能表明该人群在成年期有更显著的心血管疾病。在早产出生的个体中,即使在幼儿期,早期体重的快速增加也可能是血压升高的驱动因素。

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影响因子:1.65
发表时间:2020-01-13
来源期刊:Nursing research
DOI:10.1097/NNR.0000000000000415
作者列表:["Rodriguez J","Adams-Chapman I","Affuso O","Azuero A","Downs CA","Turner-Henson A","Rice M"]

METHODS:BACKGROUND:Preterm birth is a risk factor for elevated blood pressure in childhood and the development of hypertension and cardiometabolic disease in adulthood; however, mechanisms for the development of both are poorly understood. Rapid weight gain early in childhood may serve as a driver directly and indirectly through cortisol levels found to be elevated in early childhood in individuals born preterm. OBJECTIVES:The objective of this pilot study was to examine the effect sizes of the relationships between weight gain and blood pressure in toddlers born very preterm. A secondary aim was to note any mediating effect of cortisol on the relationships between weight gain and blood pressure. METHODS:A cross-sectional design with a convenience sample of 36 toddlers who were born very preterm was used to examine the relationships between postnatal weight gain, cortisol, and blood pressure at follow-up. RESULTS:Many of the participants experienced rapid weight gain in the first 12 months of life. Mean systolic and diastolic readings were 94 and 56.6, respectively. Diastolic blood pressure readings were obtained from 23 participants and the majority were elevated. Weight gain was associated with diastolic blood pressure with a medium effect size. A mediating role with cortisol was not supported.Although findings need to be validated in a larger sample, the blood pressure elevations in this sample were alarming. If readings continue to amplify as these children age, the fact that elevations are already present during the toddler period could indicate more significant cardiovascular disease in adulthood for this population. Rapid weight gain in early life may be a driver for elevated blood pressure even during early childhood in individuals born preterm.

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影响因子:2.3490
发表时间:2020-01-21
DOI:10.3389/fped.2019.00567
作者列表:["Camilla Sandrini","Claudio Lombardi","Andrew I. U. Shearn","Maria Victoria Ordonez","Massimo Caputo","Francesca Presti","Giovanni Battista Luciani","Lucia Rossetti","Giovanni Biglino","Giovanni Biglino"]

METHODS:This article presents a case series of n = 21 models of fetal cardiovascular anatomies obtained from post mortem microfocus computed tomography (micro-CT) data. The case series includes a broad range of diagnoses (e.g., tetralogy of Fallot, hypoplastic left heart syndrome, dextrocardia, double outlet right ventricle, atrio-ventricular septal defect) and cases also had a range of associated extra-cardiac malformations (e.g., VACTERL syndrome, central nervous system anomalies, renal anomalies). All cases were successfully reconstructed from the microfocus computed tomography data, demonstrating the feasibility of the technique and of the protocols, including in-house printing with a desktop 3D printer (Form2, Formlabs). All models were printed in 1:1 scale as well as with the 5-fold magnification, to provide insight into the intra-cardiac structures. Possible uses of the models include education and training.

影响因子:8.02
发表时间:2020-01-19
来源期刊:Genome Medicine
DOI:10.1186/s13073-019-0709-8
作者列表:["Cigdem Sevim Bayrak","Peng Zhang","Martin Tristani-Firouzi","Bruce D. Gelb","Yuval Itan"]

METHODS:Abstract Background Congenital heart disease (CHD) affects ~ 1% of live births and is the most common birth defect. Although the genetic contribution to the CHD has been long suspected, it has only been well established recently. De novo variants are estimated to contribute to approximately 8% of sporadic CHD. Methods CHD is genetically heterogeneous, making pathway enrichment analysis an effective approach to explore and statistically validate CHD-associated genes. In this study, we performed novel gene and pathway enrichment analyses of high-impact de novo variants in the recently published whole-exome sequencing (WES) data generated from a cohort of CHD 2645 parent-offspring trios to identify new CHD-causing candidate genes and mutations. We performed rigorous variant- and gene-level filtrations to identify potentially damaging variants, followed by enrichment analyses and gene prioritization. Results Our analyses revealed 23 novel genes that are likely to cause CHD, including HSP90AA1, ROCK2, IQGAP1, and CHD4, and sharing biological functions, pathways, molecular interactions, and properties with known CHD-causing genes. Conclusions Ultimately, these findings suggest novel genes that are likely to be contributing to CHD pathogenesis.

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