Intimal thickening in the coronary arteries of infants and children as an indicator of risk factors for coronary heart disease

Abstract

Narrowings of the coronary arteries were measured in 94 infants aged less than 1 year who died in hospital and 102 1- to 16-year-old children who died accidentally. The arteries were transformed mathematically to circles. The degree of narrowing caused by intimal thickening was determined as the ratio of intimal area to the original luminal area. This ratio was further transformed to percentage. The degree of narrowing varied between 0 and 58% (mean 20%). The mean degree of narrowing in the left coronary artery during the first year of life was 17% and, between 12 and 15 years, 34%. Narrowing was greater in males (P = 0.02), when all the 333 coronary samples were included in the analysis. The birthplaces of the subjects' grandparents were traced from population registers and it was found that narrowing in the left coronary artery of infants was greater in those descended from grandparents from eastern Finland, an area of high mortality from coronary heart disease (CHD). Intimal thickening in infants and children seems to be a morphological manifestation of hereditary predisposition to CHD.

Adiposity, cardiac size and precursors of coronary atherosclerosis in 5 to 15-year-old children: a retrospective study of 210 violent deaths

“…The early coronary arterial changes lie beyond the limits of clinical diagnostics, of course, and the few autopsy studies on children's coronary arteries have mainly concentrated on other traditional risk factors rather than body fatness. 1,12,13,20 Since mortality from violent causes is higher in males even in childhood, 21 the majority of the cases, as expected, were boys (n 145), and although the girls' group also proved to be quite representative (n 65), its smaller size may have affected the interpretation of the results.…”

The Role of Arterial Smooth Muscle Cells in the Pathogenesis of Atherosclerosis

“…Early lesions may go back to infancy and childhood. Thickening of the arterial intima precedes typical atherosclerotic lesions, and the degree of intimal thickening may depend on inherited as well as external factors [2]. Predilection sites of typical lesions are: (1) the abdominal aorta and iliac arteries: (2) proximal coronaries: (3) femoral and popli teal arteries as well as the thoracic aorta: (4) the internal carotid artery, and (5) vertebral arteries, the basilar artery and the circle of Willis [3].…”

A definition of the intima of human arteries and of its atherosclerosis-prone regions. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association.

“…- 55 The differences paralleled differences in coronary heart disease incidence and mortality between West and East Finland. Daoud et al, 5 * who compared intimal thickening (referred to as preatheromatous proliferative changes) in the coronary arteries of young men from New York with those in young men from East Africa, found less intimal thickening and less atherosclerosis in the East Africans.…”