title: Vascular and autonomic function in preschool-aged children with congenital heart disease.
abstract: OBJECTIVE
  To compare indices of vascular health and heart rate variability in preschool-aged children with repaired congenital heart disease (CHD) including tetralogy of Fallot (n = 6) and coarctation of the aorta (n = 6).
  
  
  METHODS
  A cross-sectional study design was used. All measures were noninvasive and collected over a single testing session under the supervision of a parent/guardian.
  
  
  METHODS
  Data collection took place in a quiet, temperature-controlled room (23°± 1°C) with the participant in a supine position.
  
  
  METHODS
  Twelve (six females, six males) preschool-aged children with repaired CHD (CHD: 4 ± 1 years) and 12 age- and gender-matched healthy controls (CON: 5 ± 1 years) participated in the study.
  
  
  METHODS
  Supine, resting measures of heart rate variability (time, frequency, and nonlinear domains), whole-body pulse wave velocity (ventricular depolarization to dorsalis pedis artery), brachial blood pressures, and carotid artery distensibility, lumen diameter, intima-media thickness, and wall/lumen ratio were collected in both groups.
  
  
  RESULTS
  The groups were similar in age, height, and weight; however, CON had significantly higher body mass index values (CON: 16.9 ± 2.2, CHD: 15.1 ± 1.0, P < .05) and body mass index percentiles (CON: 69 ± 27%tile, CHD: 36 ± 24%tile, P < .01) compared to CHD. No group differences were found for resting brachial blood pressures, whole-body pulse wave velocity, heart rate variability, and carotid artery distensibility, lumen diameter, and intima-media thickness (P > .05). Carotid artery pulse pressures (CHD: 38 ± 6 mm Hg, CON: 31 ± 6 mm Hg, P < .05) and wall/lumen ratios (CHD: 0.091 ± 0.007, CON: 0.085 ± 0.006, P < .01) were significantly higher in the CHD group.
  
  
  CONCLUSIONS
  These results may indicate that preschool-aged children with repaired CHD display early signs of vascular remodeling, but not autonomic or vascular dysfunction. The effects of larger wall/lumen ratios on cardiovascular disease risk require further investigation.
authors.affiliation: Department of Kinesiology Child Health and Exercise Medicine Program, McMaster Children's Hospital, Hamilton, ON, Canada.
authors.forename: Katharine D
authors.initials: KD
authors.lastname: Currie
authors.forename: Audra A
authors.initials: AA
authors.lastname: Martin
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Millar
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Stone
authors.forename: Brian W
authors.initials: BW
authors.lastname: Timmons
authors.forename: Rejane F
authors.initials: RF
authors.lastname: Dillenburg
authors.forename: Maureen J
authors.initials: MJ
authors.lastname: MacDonald
mesh_terms: D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002339:Carotid Arteries / Q000473:pathology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003187:Compliance; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology / Q000503:physiopathology*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009864:Ontario; D056888:Patient Positioning; D017156:Photoplethysmography; D011673:Pulsatile Flow; D016683:Supine Position