Carotid artery stiffness as an early marker of vascular lesions in children and adolescents with cardiovascular risk factors.
OBJECTIVE
The availability of a noninvasive marker of vascular lesions that enables their detection in the preclinical phase would be of great benefit for cardiovascular disease prevention. The aim of this study was to investigate the usefulness of a range of indices of arterial wall stiffness in the common carotid artery, as derived using high-resolution Doppler ultrasonography, for identifying vascular damage in children with risk factors.


METHODS
The study involved 99 children (age, 8-16 years) divided into two groups: 65 had cardiovascular risk factors (45 obesity, 20 dyslipidemia) and 34 were controls. Family histories of cardiovascular risk factors and anthropometric and biochemical measurements were recorded. Functional parameters of arterial stiffness (i.e., arterial compliance, elastic modulus, beta stiffness index, pulse wave velocity, and augmentation index) and the intima-media thickness were also measured.


RESULTS
Some functional vascular parameters were higher in obese children than controls: there were significant differences in beta stiffness index (P< .02), elastic modulus (P< .001) and pulse wave velocity (P< .01). There was a significant difference in arterial compliance between dyslipidemics and controls (P< .05). No significant difference in intima-media thickness was found between the groups. In obese children, there were positive correlations between body mass index, systolic pressure and triglyceride levels and vascular parameters (i.e., elastic modulus and pulse wave velocity); in dyslipidemic children, triglyceride levels and the same parameters were correlated.


CONCLUSIONS
Ultrasonographic measurement of arterial stiffness is a sensitive technique that can detect vascular damage in children with cardiovascular risk factors earlier than intima-media thickness measurement.
Unidad de Cardiología Pediátrica, Servicio de Pediatría, Hospital Clínico Universitario de Valencia, Valencia, España.
Francisco
F
Núñez
Cecilia
C
Martínez-Costa
Julia
J
Sánchez-Zahonero
Julia
J
Morata
Francisco Javier
FJ
Chorro
Juan
J
Brines
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D050171:Dyslipidemias / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000000981:diagnostic imaging*; D012307:Risk Factors; D018608:Ultrasonography, Doppler