title: Beyond intima-media-thickness: Analysis of the carotid intima-media-roughness in a paediatric population.
abstract: Subclinical atherosclerosis assessed by sonographic intima-media-thickness measurement of the carotid artery (cIMT) is considered to be an early precursor of cardiovascular disease already in childhood. Structural analysis of the carotid intimal layer (carotid intima-media-roughness, cIMR) improves cardiovascular risk profiling for the adult patient and has been shown to be increased also in paediatric patients with elevated cardiovascular risk. To date, normal values for the paediatric age are lacking. Thus, we present normative data for a paediatric age group.
  
  
  
  602 healthy German school children (age 8-18 y) were studied, and cIMT and cIMR calculated; reference values were given for three age groups (group 1: 8-10.99 years; group 2: 11-13.99 years; group 3: 14-17.99 years).
  
  
  
  cIMT values were: 0.48 ± 0.03 mm for girls and boys in age group 1, 0.49 ± 0.03 mm for girls and boys in age group 2; and 0.45 ± 0.03 mm for girls and 0.49 ± 0.03 mm for boys in age group 3; cIMR was 0.04 ± 0.01 mm for both sexes in age group 1 and 3; while in age group 2, both sexes showed a cIMR of 0.03 ± 0.01 mm. Physical fitness was significantly negatively correlated with cIMR (r = - 0.212, p < 0.0001) and a strong predictor for cIMR increase.
  
  
  
  The normative data of cIMR for a paediatric age group presented here allow for the identification of patients at elevated cardiovascular risk. By including cIMR as surface analysis of the arterial wall, the individual risk stratification may be improved compared to thickness-analysis of the Intima-Media-Layer (cIMT) also at a paediatric age.
authors.affiliation: Department of Pediatric Cardiology, Ludwig Maximilians-University of Munich, Marchioninistr. 15, D-81377 Munich, Germany. Electronic address: Robert.Dallapozza@med.lmu.de.
authors.forename: Robert
authors.initials: R
authors.lastname: Dalla Pozza
authors.affiliation: Department of Pediatric Cardiology, Ludwig Maximilians-University of Munich, Marchioninistr. 15, D-81377 Munich, Germany.
authors.forename: Raphael
authors.initials: R
authors.lastname: Pirzer
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany. Electronic address: andreas.beyerlein@helmholtz-muenchen.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Beyerlein
authors.affiliation: Institute of Preventive Paediatrics, Technical University of Munich, Uptown Munich, Georg-Brauchle-Ring 62, D-80992 Munich, Germany. Electronic address: heidi.weberruss@tum.de.
authors.forename: Heidi
authors.initials: H
authors.lastname: Weberruß
authors.affiliation: Institute of Preventive Paediatrics, Technical University of Munich, Uptown Munich, Georg-Brauchle-Ring 62, D-80992 Munich, Germany. Electronic address: renate.oberhoffer@tum.de.
authors.forename: Renate
authors.initials: R
authors.lastname: Oberhoffer
authors.affiliation: Institute of Exercise and Health Sciences, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland. Electronic address: arno.schmidt-trucksaess@unibas.ch.
authors.forename: Arno
authors.initials: A
authors.lastname: Schmidt-Trucksäss
authors.affiliation: Department of Pediatric Cardiology, Ludwig Maximilians-University of Munich, Marchioninistr. 15, D-81377 Munich, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Netz
authors.affiliation: Department of Pediatric Cardiology, Ludwig Maximilians-University of Munich, Marchioninistr. 15, D-81377 Munich, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Haas
mesh_terms: D000293:Adolescent; D002309:Cardiology / Q000592:standards; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005858:Germany; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography
keywords: Carotid intima media roughness; Carotid intima media thickness; Carotid ultrasound; Subclinical atherosclerosis