High prevalence of interatrial septal aneurysm in young adults who were born preterm

Abstract

Background: The cardiovascular vulnerability of young adults who were born preterm was first acknowledged over a decade ago.

Aims: (1) To examine the echocardiographic characteristics of a group of young adults born preterm with an extremely low birthweight (<1000 g; ex-ELBW) in comparison with healthy controls born at term (C); (2) to identify a correlation between the potential echocardiographic abnormalities detected in ex-ELBW and their anthropometric parameters, age, presence of respiratory distress, patency of ductus arteriosus, length of stay in Neonatal Intensive Care Unit.

Methods: Thirty-seven ex-ELBW (11 males, 26 females; mean age: 22.2 ± 1.8 years) were compared with 37 C (11 males, 26 females). Both groups underwent standard mono- and bi-dimensional transthoracic echocardiogram with color Doppler.

Results: No statistically significant differences were detected between the two groups regarding mono-dimensional echocardiography or Doppler measurements (p = ns).

Conversely, a statistically significant difference was observed between the prevalence of interatrial septal aneurysm (ASA) in ex-ELBW compared to C (p = 0.0016). A significant association was likewise observed between ASA and the presence of both respiratory distress at birth (p < 0.05) and patency of the ductus arteriosus (p < 0.05).

Conclusions: A significant prevalence of ASA was detected in ex-ELBW subjects compared to C, underlining a probable correlation with respiratory distress and patent ductus arteriosus. In view of the association between ASA and stroke in young adults devoid of other cerebrovascular risk factors, this unexpected observation suggests that all ex-preterm subjects should undergo transthoracic or transesophageal echocardiographic examination with the aim of detecting this potentially emboligenic cardiac abnormality.

• Interatrial septal aneurysm
• migraine
• patent foramen ovale
• prematurity
• stroke