Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure.
OBJECTIVE
To determine the association between carotid artery intimal-medial thickness (cIMT) and left ventricular mass index (LVMI) in children with elevated blood pressure.


METHODS
Study subjects (n = 32; mean age: 13.9 +/- 2.7 years) were untreated new referrals to a pediatric hypertension clinic with confirmed elevated blood pressure. LVM was calculated from 2-dimensionally guided m-mode echocardiographic measurements of the left ventricle. LVMI was calculated as LVM (g)/height (m)2.7, and left ventricular hypertrophy (LVH) was defined as LVMI >95th percentile. Carotid artery duplex ultrasound was performed by protocol by experienced vascular sonographers who were unaware of the echocardiography results. The thickest IMT complex of the far wall of the distal common carotid artery was measured in longitudinal B-mode section using a high-resolution linear array of 8 MHz.


RESULTS
The prevalence of LVH and increased cIMT was 41% and 28%, respectively. Subjects with increased cIMT had higher LVMI (46.8 g/m2.7 vs 31.4 g/m2.7) than those with normal cIMT. The LVH prevalence was 89% (8 of 9) among subjects with increased cIMT as compared with 22% (5 of 23) in subjects with normal cIMT. cIMT was positively correlated with body mass index (r = 0.43), interventricular septal thickness (r = 0.58), posterior wall thickness (r = 0.54), and LVMI (r = 0.54). cIMT and LVMI were positively associated after accounting for age, gender, and body mass index.


CONCLUSIONS
These findings raise the possibility that carotid duplex ultrasound, by indicating the presence of early arterial wall changes, may be useful for predicting other cardiovascular sequelae in hypertensive children.
Sorof
Jonathan M
JM
Department of Pediatrics, University of Texas Medical School at Houston, Houston, Texas 77030, USA. jsorof@uth.tmc.edu
Alexandrov
Andrei V
AV
Cardwell
Gina
G
Portman
Ronald J
RJ
D000293:Adolescent; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012044:Regression Analysis