{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T07:07:52Z","timestamp":1792739272944,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,6,8]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Fetal growth restriction (FGR) affects 5% to 10% of newborns and is associated with increased cardiovascular mortality in adulthood. The most commonly accepted hypothesis is that fetal metabolic programming leads secondarily to diseases associated with cardiovascular disease, such as obesity, diabetes mellitus, and hypertension. Our main objective was to evaluate the alternative hypothesis that FGR induces primary cardiac changes that persist into childhood.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Within a cohort of fetuses with growth restriction identified in fetal life and followed up into childhood, we randomly selected 80 subjects with FGR and compared them with 120 normally grown fetuses, matched for gender, birth date, and gestational age at birth. Cardiovascular assessment was performed in childhood (mean age of 5 years). Compared with control subjects, children with FGR had a different cardiac shape, with increased transversal diameters and more globular cardiac ventricles. Although left ejection fraction was similar among the study groups, stroke volume was reduced significantly, which was compensated for by an increased heart rate to maintain output in severe FGR. This was associated with subclinical longitudinal systolic dysfunction (decreased myocardial peak velocities) and diastolic changes (increased E\/E\u2032 ratio and E deceleration time). Children with FGR also had higher blood pressure and increased intima-media thickness. For all parameters evaluated, there was a linear increase with the severity of growth restriction.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    These findings suggest that FGR induces primary cardiac and vascular changes that could explain the increased predisposition to cardiovascular disease in adult life. If these results are confirmed, the impact of strategies with beneficial effects on cardiac remodeling should be explored in children with FGR.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.110.937995","type":"journal-article","created":{"date-parts":[[2010,5,24]],"date-time":"2010-05-24T22:29:24Z","timestamp":1274740164000},"page":"2427-2436","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":389,"title":["Fetal Growth Restriction Results in Remodeled and Less Efficient Hearts in Children"],"prefix":"10.1161","volume":"121","author":[{"given":"Fa\u0300tima","family":"Crispi","sequence":"first","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Bijnens","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Figueras","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Bartrons","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisenda","family":"Eixarch","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand","family":"Le Noble","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Ahmed","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Grataco\u0301s","sequence":"additional","affiliation":[{"name":"From the Department of Maternal-Fetal Medicine (Institut Cli\u0301nic de Ginecologia, Obstetri\u0301cia i Neonatologia), Hospital Clinic-IDIBAPS, University of Barcelona, and Centro de Investigacio\u0301n Biome\u0301dica en Red en Enfermedades Raras (F.C., F.F., E.E., E.G.), Barcelona, Spain; ICREA-Universitat Pompeu Fabra (CISTIB) and Centro de Investigacio\u0301n Biome\u0301dica en Red en Bioingenieri\u0301a, Biomateriales y Nanomedicina (B.B.), Barcelona, Spain; Department of Pediatric Cardiovascular Surgery, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(02)02418-9"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/pdp.21.2.213.237"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6673.564"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.710715"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01670.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.750133"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-999333"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3934"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.056"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1203\/01.PDR.0000061564.86797.78"},{"key":"e_1_3_2_11_2","first-page":"1484","volume":"23","year":"2005","unstructured":"Skilton MK, Evans N, Griffiths KA, Harmer JA, Celermajer D. 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