Feasibility and characteristics of arterial stiffness measurement in preschool children

Abstract

BackgroundArterial stiffness is an important predictor of cardiovascular risk in adult life. Increased arterial stiffness can also be present in children and may be associated with several other cardiovascular risk factors. Until now, however, we know little about measuring arterial stiffness in preschool children. In this study, we assessed the feasibility of measuring arterial stiffness in preschool children and explored possible determinants related to arterial stiffness at this age.MethodsWe studied 168 healthy children, aged 3.3–4.1 years, who were recruited from a prospective birth cohort. We measured arterial stiffness, expressed in aortic pulse wave velocity and augmentation index, using a non-invasive oscillometric device (Arteriograph). We measured anthropometry and recorded other determinants using a questionnaire.ResultsIn 100 children (59.5%) at least one valid arterial stiffness measurement was obtained. Of these infants, 89 had at least two valid measurements and 73 infants had at least three valid measurements. The mean aortic pulse wave velocity was 5.56 m/s (SD 0.77), and the mean augmentation index of the aorta was 19.7 m/s (SD 7.0). The augmentation index was significantly inversely associated with body height, with a regression coefficient of –0.78 (m/s)/cm (95% confidence interval –1.13 to –0.42). The augmentation index was not significantly associated with age, sex or (birth) weight.ConclusionThe feasibility of measuring arterial stiffness in preschool children using the Arteriograph is moderate. We identified height as the most important determinant of the augmentation index in preschool children.

Reference Intervals of Central Aortic Blood Pressure and Augmentation Index Assessed with an Oscillometric Device in Healthy Children, Adolescents, and Young Adults from Argentina

“…This validated system provides central aortic BP values that have shown significant correlation with values of cSBP invasively assessed [ 6 , 23 ]. On the other hand, the use of an arm cuff facilitates epidemiological studies performed in large cohort including children and adolescents [ 14 , 17 , 33 ]. Moreover, the Arteriograph device allows simultaneous quantification of Ao-PWV, AIx, cSBP, and peripheral BP, and the procedure takes only 2-3 min and is well tolerated even in preschool children who experienced only a little discomfort, similar to that observed during noninvasive BP measurement [ 14 ].…”

“…They include Doppler ultrasound, applanation tonometry, oscillometry, and magnetic resonance imaging; all of them are associated with its own strengths and weaknesses [ 2 , 12 ]. Oscillometric devices have been suggested to be especially adequate in children and adolescents, since the methodology includes the use of a simple pressure cuff and have the advantages of being relatively fast, operator independent and require minimal cooperation of the patient [ 13 , 14 ].…”

Young patients with cystic fibrosis demonstrate subtle alterations of the cardiovascular system

“…Blood pressure and aortic pulse wave velocity, a measure of arterial stiffness, were measured at rest in a calm and supine position using the Arteriograph (Tensiomed, Budapest, Hungary) at the end of the echocardiographic examination of ±30 min. The Arteriograph is a non-invasive oscillometric device of which method and validation have been described previously [15][16][17][18]. A higher pulse wave velocity indicates a stiffer artery.…”

Editor’s Presentation

“…Previous studies showed a feasibility of assessing arterial stiffness in children 19 and in patients with congenital heart disease (CHD). 20 It has been hypothesized that patients with CHD have increased arterial stiffness already at an early age, and that this early vascular stiffening predisposes children to premature myocardial remodelling and cardiac damages later in life.…”