Thesis defence in the University of Oulu

Doctoral Candidate

Licentiate of Medicine Nelli Korpela

Faculty and research unit

University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu

Field of study


Date and time of the thesis defence

12.6.2020 12:00

Place of the thesis defence

Remote access:

Topic of the dissertation

Determinants of cardiovascular autonomic regulation and cardiac structure in a middle-aged population – influence of early growth related factors and life course physical activity


Docent Tiina Ojala, University of Helsinki


Professor Heikki Huikuri, University of Oulu

Fetal and childhood growth are associated with cardiac autonomic regulation and cardiac structure in adulthood

In this dissertation study, we found that early growth patterns are associated with cardiac autonomic regulation and cardiac structure in adulthood. These findings support the concept that fetal and childhood growth contribute to cardiovascular health in adulthood.

Increasing evidence suggests that the factors influencing cardiovascular morbidity have an early origin, beginning even before birth and in childhood. Autonomic cardiac regulation is disturbed in various manifestations of cardiovascular disease, and cardiac left ventricular structure is associated with cardiovascular morbidity and mortality in adulthood. The main objective of this dissertation was to investigate the relationships of birth weight and childhood growth patterns with cardiac autonomic regulation, structure, and function in a middle-aged population. The study was based on data of the Northern Finland 1966 Birth Cohort collected at fetal period, birth, childhood and 46 years of age. At 46 years of age heart rate variability and baroreflex sensitivity, which reflect cardiac autonomic regulation, were evaluated. For a subpopulation, an echocardiographic examination was also conducted.

The results of this dissertation study showed that in men, higher birth weight is associated with impaired cardiac autonomic regulation in adulthood, but birth weight did not have a substantial association with left ventricular structure or function in adulthood. Growth patterns in early childhood, particularly an early adiposity rebound and a higher body mass index in infancy and childhood, were associated with impaired cardiovascular autonomic regulation and alterations in cardiac structure in adulthood. The dissertation study also found that life course physical activity is favorably associated with autonomic cardiac regulation in adulthood.

Cardiovascular diseases remain a leading cause of death in Finland and globally. Understanding pathways related to cardiovascular health and disease have important public health significance.



Last updated: 5.6.2020