Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial

Winok Lapidaire; Afifah Mohamed; Wilby Williamson; Odaro J. Huckstep; Maryam Alsharqi; Cheryl M.J. Tan; Samuel Burden; Cameron Dockerill; William Woodward; Annabelle McCourt; Holger Burchert; Yvonne Kenworthy; Luca Biasiolli; Helen Dawes; Charlie Foster; Paul Leeson; Adam J. Lewandowski

doi:10.1016/j.jacadv.2025.101721

Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial

Winok Lapidaire, Afifah Mohamed, Wilby Williamson, Odaro J. Huckstep, Maryam Alsharqi, Cheryl M.J. Tan, Samuel Burden, Cameron Dockerill, William Woodward, Annabelle McCourt, Holger Burchert, Yvonne Kenworthy, Luca Biasiolli, Helen Dawes, Charlie Foster, Paul Leeson, Adam J. Lewandowski^*

^*Corresponding author for this work

Bristol Medical School (PHS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

1 Citation (Scopus)

Abstract

Background
People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation.

Objectives
The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention.

Methods
We conducted a randomized controlled trial in 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension. Participants were randomized 1:1 to a 16-week aerobic exercise intervention or to a control group. In a prespecified cardiovascular magnetic resonance imaging (CMR) substudy, CMR was performed at 3.0-Tesla to assess left and right ventricular (LV and RV) structure and function before and after intervention.

Results
A total of 100 participants completed CMR scans at baseline and after the 16-week intervention, with n = 47 in the exercise intervention group (n = 26 term-born; n = 21 preterm-born) and n = 53 controls (n = 32 term-born; n = 21 preterm-born). In term-born participants, LV mass to end-diastolic volume ratio decreased (−3.43; 95% CI: −6.29 to −0.56; interaction P = 0.027) and RV stroke volume index increased (5.53 mL/m2; 95% CI: 2.60, 8.47; interaction P = 0.076) for those in the exercise intervention group vs controls. No significant effects were observed for cardiac structural indices in preterm-born participants. In preterm-born participants, LV basal- and mid-ventricular circumferential strain increased (−1.33; 95% CI: −2.07 to −0.60; interaction P = 0.057 and −1.54; 95% CI: −2.46 to −0.63; interaction P = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: −3.12 to −0.87; interaction P = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants.

Conclusions
Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.

Original language	English
Article number	101721
Number of pages	11
Journal	JACC Advances
Volume	4
Issue number	5
Early online date	29 Apr 2025
DOIs	https://doi.org/10.1016/j.jacadv.2025.101721
Publication status	Published - 1 May 2025

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© 2025 The Authors

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Lapidaire, W., Mohamed, A., Williamson, W., Huckstep, O. J., Alsharqi, M., Tan, C. M. J., Burden, S., Dockerill, C., Woodward, W., McCourt, A., Burchert, H., Kenworthy, Y., Biasiolli, L., Dawes, H., Foster, C., Leeson, P., & Lewandowski, A. J. (2025). Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial. JACC Advances, 4(5), Article 101721. https://doi.org/10.1016/j.jacadv.2025.101721

@article{dbb96ae55eb84cb5820d9291a32896aa,

title = "Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial",

abstract = "Background People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation. Objectives The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention. Methods We conducted a randomized controlled trial in 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension. Participants were randomized 1:1 to a 16-week aerobic exercise intervention or to a control group. In a prespecified cardiovascular magnetic resonance imaging (CMR) substudy, CMR was performed at 3.0-Tesla to assess left and right ventricular (LV and RV) structure and function before and after intervention. Results A total of 100 participants completed CMR scans at baseline and after the 16-week intervention, with n = 47 in the exercise intervention group (n = 26 term-born; n = 21 preterm-born) and n = 53 controls (n = 32 term-born; n = 21 preterm-born). In term-born participants, LV mass to end-diastolic volume ratio decreased (−3.43; 95\% CI: −6.29 to −0.56; interaction P = 0.027) and RV stroke volume index increased (5.53 mL/m2; 95\% CI: 2.60, 8.47; interaction P = 0.076) for those in the exercise intervention group vs controls. No significant effects were observed for cardiac structural indices in preterm-born participants. In preterm-born participants, LV basal- and mid-ventricular circumferential strain increased (−1.33; 95\% CI: −2.07 to −0.60; interaction P = 0.057 and −1.54; 95\% CI: −2.46 to −0.63; interaction P = 0.046, respectively) and RV global longitudinal strain increased (1.99\%; 95\% CI: −3.12 to −0.87; interaction P = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants. Conclusions Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.",

author = "Winok Lapidaire and Afifah Mohamed and Wilby Williamson and Huckstep, \{Odaro J.\} and Maryam Alsharqi and Tan, \{Cheryl M.J.\} and Samuel Burden and Cameron Dockerill and William Woodward and Annabelle McCourt and Holger Burchert and Yvonne Kenworthy and Luca Biasiolli and Helen Dawes and Charlie Foster and Paul Leeson and Lewandowski, \{Adam J.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = may,

day = "1",

doi = "10.1016/j.jacadv.2025.101721",

language = "English",

volume = "4",

journal = "JACC Advances",

issn = "2772-963X",

publisher = "Elsevier",

number = "5",

}

Lapidaire, W, Mohamed, A, Williamson, W, Huckstep, OJ, Alsharqi, M, Tan, CMJ, Burden, S, Dockerill, C, Woodward, W, McCourt, A, Burchert, H, Kenworthy, Y, Biasiolli, L, Dawes, H, Foster, C, Leeson, P & Lewandowski, AJ 2025, 'Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial', JACC Advances, vol. 4, no. 5, 101721. https://doi.org/10.1016/j.jacadv.2025.101721

TY - JOUR

T1 - Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial

AU - Lapidaire, Winok

AU - Mohamed, Afifah

AU - Williamson, Wilby

AU - Huckstep, Odaro J.

AU - Alsharqi, Maryam

AU - Tan, Cheryl M.J.

AU - Burden, Samuel

AU - Dockerill, Cameron

AU - Woodward, William

AU - McCourt, Annabelle

AU - Burchert, Holger

AU - Kenworthy, Yvonne

AU - Biasiolli, Luca

AU - Dawes, Helen

AU - Foster, Charlie

AU - Leeson, Paul

AU - Lewandowski, Adam J.

PY - 2025/5/1

Y1 - 2025/5/1

N2 - Background People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation. Objectives The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention. Methods We conducted a randomized controlled trial in 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension. Participants were randomized 1:1 to a 16-week aerobic exercise intervention or to a control group. In a prespecified cardiovascular magnetic resonance imaging (CMR) substudy, CMR was performed at 3.0-Tesla to assess left and right ventricular (LV and RV) structure and function before and after intervention. Results A total of 100 participants completed CMR scans at baseline and after the 16-week intervention, with n = 47 in the exercise intervention group (n = 26 term-born; n = 21 preterm-born) and n = 53 controls (n = 32 term-born; n = 21 preterm-born). In term-born participants, LV mass to end-diastolic volume ratio decreased (−3.43; 95% CI: −6.29 to −0.56; interaction P = 0.027) and RV stroke volume index increased (5.53 mL/m2; 95% CI: 2.60, 8.47; interaction P = 0.076) for those in the exercise intervention group vs controls. No significant effects were observed for cardiac structural indices in preterm-born participants. In preterm-born participants, LV basal- and mid-ventricular circumferential strain increased (−1.33; 95% CI: −2.07 to −0.60; interaction P = 0.057 and −1.54; 95% CI: −2.46 to −0.63; interaction P = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: −3.12 to −0.87; interaction P = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants. Conclusions Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.

AB - Background People born preterm (<37 weeks' gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation. Objectives The authors investigated whether preterm-born and term-born adults exhibit similar cardiac structural and functional remodeling following a 16-week aerobic exercise intervention. Methods We conducted a randomized controlled trial in 203 adults (aged 18-35 years) with elevated blood pressure or stage 1 hypertension. Participants were randomized 1:1 to a 16-week aerobic exercise intervention or to a control group. In a prespecified cardiovascular magnetic resonance imaging (CMR) substudy, CMR was performed at 3.0-Tesla to assess left and right ventricular (LV and RV) structure and function before and after intervention. Results A total of 100 participants completed CMR scans at baseline and after the 16-week intervention, with n = 47 in the exercise intervention group (n = 26 term-born; n = 21 preterm-born) and n = 53 controls (n = 32 term-born; n = 21 preterm-born). In term-born participants, LV mass to end-diastolic volume ratio decreased (−3.43; 95% CI: −6.29 to −0.56; interaction P = 0.027) and RV stroke volume index increased (5.53 mL/m2; 95% CI: 2.60, 8.47; interaction P = 0.076) for those in the exercise intervention group vs controls. No significant effects were observed for cardiac structural indices in preterm-born participants. In preterm-born participants, LV basal- and mid-ventricular circumferential strain increased (−1.33; 95% CI: −2.07 to −0.60; interaction P = 0.057 and −1.54; 95% CI: −2.46 to −0.63; interaction P = 0.046, respectively) and RV global longitudinal strain increased (1.99%; 95% CI: −3.12 to −0.87; interaction P = 0.053) in the exercise intervention group vs controls. No significant effects were observed for myocardial deformation parameters in term-born participants. Conclusions Aerobic exercise training induces improved myocardial function but not cardiac structure in preterm-born adults.

U2 - 10.1016/j.jacadv.2025.101721

DO - 10.1016/j.jacadv.2025.101721

M3 - Article (Academic Journal)

C2 - 40300305

SN - 2772-963X

VL - 4

JO - JACC Advances

JF - JACC Advances

IS - 5

M1 - 101721

ER -

Exercise Improves Myocardial Deformation But Not Cardiac Structure in Preterm-Born Adults A Randomized Clinical Trial

Abstract

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