Intima–media thickness measurements in children with cardiovascular risk factors

Abstract

Measuring intima-media thickness (IMT) is now a standard diagnostic procedure in assessing cardiovascular risk and hypertensive target-organ damage (TOD) in adults. There is also an increasing number of pediatric publications evaluating IMT in children from high-risk groups, such as those with arterial hypertension, diabetes, chronic kidney disease, obesity, dyslipidemia, and homocystinurias. It has been shown that carotid IMT is strongly related with other markers of TOD in children with arterial hypertension and with metabolic cardiovascular risk factors. In children with coarctation of the aorta, carotid IMT correlated both with blood pressure and even with mild residual aortic gradient. On the other hand, studies in children with high cardiovascular risk have shown that normalization of blood pressure and metabolic abnormalities led to regression of arterial changes and decrease of IMT. Although not yet accepted as standard pediatric procedure, IMT measurement is emerging as a promising method of assessing TOD and cardiovascular risk and monitoring treatment efficacy. From a practical point of view, clinical utility of IMT measurements seems to be similar to use of echocardiography in assessing left ventricular mass. However, IMT measurements in children and adolescents should be standardized to avoid bias caused by the use of different measurement methods.

Selective Intrauterine Growth Restriction in Monochorionic Twin Pregnancies: Markers of Endothelial Damage and Metabolomic Profile

“…Intima-media thickness is currently considered to be one of the earliest morphological markers of plaque formation and atherosclerosis in IUGR fetuses and neonates (Cosmi et al, 2009;Järvisalo et al, 2001;Koklu et al, 2007;Litwin & Niemirska, 2008;McGill et al, 2000;Skilton, 2008;Zanardo et al, 2011Zanardo et al, , 2013.…”

Coarctation of the Aorta and Coronary Artery Disease

“…Several studies have shown that patients with CoA may have higher rates of endothelial dysfunction, circulating levels of proinflammatory cytokines, and vascular stiffness, and some of these studies have shown that these abnormalities may persist even after repair, suggesting the possibility of an inherent defect in vascular reactivity. 9,10,13,17 If these patients have innate vascular reactivity defects, they can potentially predispose to the development of CAD regardless of repair. Although some of these studies looked at potential novel mechanisms of disease, many of them enrolled only a small number of patients; thus, the potential for drawing clinical conclusions from them is limited.…”

Zalecenia Sekcji Pediatrycznej Polskiego Towarzystwa Nadciśnienia Tętniczego dotyczące postępowania diagnostycznego i terapeutycznego w nadciśnieniu tętniczym u dzieci i młodzieży

“…During the last decade, multiple reports have been published that support using cIMT and PWV measurements to evaluate target organ damage, and pediatric reference values for cIMT and PWV have been published (Table V and VI) [37][38][39][40][41][42]. These tests are already recommended (ESH 2016) as additional in the assessment of target organ damage in children with AH.…”