- Title
- Cardiac development and remodeling in preterm infants
- Creator
- Phad, Nilkant Santram
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2020
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Prematurity, defined as birth before 37 weeks of gestation, is a major public health problem worldwide. Every year, over 15 million infants are born preterm globally and the number is increasing. The mortality of preterm infants has declined dramatically over last few decades due to advances in the obstetric and neonatal intensive care. However, the morbidity related to preterm birth has remained relatively unchanged over the years leading to a growing population of children and adults with the sequelae of preterm birth. Epidemiological studies show that until full term gestation, optimal intrauterine environment is obligatory for normal organ development and maturation of physiological systems. Exposure to adverse conditions in early life can increase disease risk in the future through altered developmental programming of organs and systems. Organs which involve cellular multiplication and branching morphogenesis during intrauterine life are particularly affected. Preterm infants are abruptly exposed to the extrauterine environment at a time when organ development is incomplete and the body systems are functionally immature. The extrauterine environment is fundamentally different from the intrauterine environment and comparatively suboptimal for supporting normal growth and development of organs. Similar to growth restricted infants, organs and systems of preterm infants also show adaptive structural and functional changes in response to the challenges of extrauterine environment. The postnatal adaptive changes which confer immediate survival benefit are, however, long lasting and place preterm infants at a higher risk of organ dysfunction, morbidity and mortality in future. The link between preterm birth and significantly higher prevalence of neurodevelopmental disorders, blindness, hearing impairment, respiratory ill-health, hypertension and metabolic syndrome confirms the concept of altered organ development following preterm birth. In this project, through a series of chapters, we studied early cardiac remodeling in preterm infants. The development of systolic and diastolic function of the immature myocardium during the neonatal intensive care period was assessed longitudinally using conventional and novel echocardiographic techniques. Parameters indicative of left ventricular (LV) remodeling in response to a wide range hemodynamic conditions were used to determine the comparative pattern of LV geometry in preterm infants at 36 weeks post menstrual age (PMA).
- Subject
- prematurity; cardiac remodelling; infant mortality; full term gestation; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1428527
- Identifier
- uon:38638
- Rights
- Copyright 2020 Nilkant Santram Phad
- Language
- eng
- Full Text
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| View Details Download | ATTACHMENT01 | Thesis | 1 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 211 KB | Adobe Acrobat PDF | View Details Download |