Low birth weight associations with cardiac structure and function in adults after arterial switch for transposition of the great arteries

International Journal of Cardiology Congenital Heart Disease, vol. 18, pp. 100550

Abstract

The objective of this study was to assess the associations of birth weight with cardiac structure and function in adults with dextro-transposition of the great arteries (D-TGA) who underwent the arterial switch operation (ASO). Thirty-nine ASO patients (age 24.4 ± 3.3 years) were included during routine clinical follow-up from July 2019 to December 2021. All patients underwent cardiopulmonary exercise testing and cardiac magnetic resonance imaging at rest and during exercise. Early-life characteristics, including birth weight, were extracted from electronic medical health records. Linear regression analysis showed that lower birth weight was associated with smaller left ventricular (LV) and right ventricular (RV) end-diastolic volume index (LV: −14.5 mL/m 2 [95 % confidence interval, CI: −26.5 to −2.5] per 1-kg decrease in birth weight, p = 0.04; RV: −11.2 mL/m 2 [-20.7 to −1.7] per 1-kg decrease in birth weight, p = 0.03). Lower birth weight was associated with greater LV and RV ejection fraction at rest (LV: +8.5 % [+4.4 to +12.5] per 1-kg decrease in birth weight, p < 0.001); RV: +8.1 % [+2.8 to +13.4] per 1-kg decrease in birth weight, p = 0.005). Furthermore, lower birth weight was associated with an attenuated increase in LV stroke volume index from rest to peak exercise (−5.2 mL/m 2 [-9.3 to −1.2] per 1-kg decrease in birth weight, p = 0.02). Birth weight may be a novel risk factor for adverse cardiac remodeling in adult ASO patients. Further research is needed to delineate the mechanisms underlying the associations between birth weight and cardiac remodeling ASO patients as well as the broader adult CHD population.

Authors 10

1. Art Schuermans

   Broad Institute · Harvard University · Massachusetts General Hospital · KU Leuven

   Affiliation as printed

   Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA

   Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

   Program in Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, MA, USA

2. Béatrice Santens

   Universitair Ziekenhuis Leuven · KU Leuven

   Affiliation as printed

   Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium

   Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

3. Jef Van den Eynde

   Universitair Ziekenhuis Leuven · KU Leuven

   Affiliation as printed

   Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium

   Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

4. Xander Jacquemyn

   Johns Hopkins University · Johns Hopkins Hospital · KU Leuven

   Affiliation as printed

   Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

   Helen B. Taussig Heart Center, Johns Hopkins Hospital and School of Medicine, Baltimore, MD, USA

5. Roel L.F. van der Palen Aachen Department of Pediatrics Division of Pediatric Cardiology

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Pediatrics, Division of Pediatric Cardiology, Leiden University Medical Centre LUMC, Leiden, the Netherlands

6. Michael C. Honigberg

   Broad Institute · Harvard University · Massachusetts General Hospital

   Affiliation as printed

   Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA

   Department of Medicine, Harvard Medical School, Boston, MA, USA

   Program in Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, MA, USA

7. Alexander Van De Bruaene

   Universitair Ziekenhuis Leuven · KU Leuven

   Affiliation as printed

   Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium

   Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

8. Piet Claus

   KU Leuven

   Affiliation as printed

   Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

9. Jan G. Bogaert

   Universitair Ziekenhuis Leuven · KU Leuven

   Affiliation as printed

   Department of Imaging and Pathology, KU Leuven, Leuven, Belgium

   Department of Radiology, UZ Leuven, Leuven, Belgium

10. Werner Budts corresponding

    Universitair Ziekenhuis Leuven · KU Leuven

    Affiliation as printed

    Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium

    Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium