Barker, David J.P., Gelow, Jill, Thornburg, Kent, Osmond, Clive, Kajantie, Eero and Eriksson, Johan G.
The early origins of chronic heart failure: impaired placental growth and initiation of insulin resistance in childhood
European Journal of Heart Failure, 12, (8), . (doi:10.1093/eurjhf/hfq069). (PMID:20504866).
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Aims: Low birth weight and low placental weight predict later coronary heart disease and hypertension. This has led to the hypothesis that these diseases are initiated by foetal programming, the process by which foetal malnutrition leads to permanent changes in the body in ways that lead to chronic disease in later life. Here we examine the association between body and placental size at birth and later chronic heart failure.
Methods and results: We identified 187 patients taking medications for chronic heart failure in a birth cohort of 13 345 people born in Helsinki, Finland during 1934–44. Chronic heart failure was associated with a small placental surface area. In people born with a placental area less than 225 cm2, the odds ratio for chronic heart failure was 1.7 (1.1–2.5), compared with people born with a placental area greater than 295 cm2. The risk of heart failure was further increased by rapid gain in body mass index after the age of 2 years, a path of growth known to be linked to insulin resistance in later life. In a simultaneous regression, low body mass index at 2 years and high body mass index at 11 years were each associated with chronic heart failure (P = 0.008 and 0.001, respectively).
Conclusion: Chronic heart failure in adult life may be initiated by impaired
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