Pediatric obstructive sleep-disordered breathing is associated with arterial stiffness

Monteiro, Eduardo Machado Rossi; Sefair, Laura Rodrigues; Lima, Marcos Correia; Nascimento, Maria Fernanda Lima; Pinto, Daniel Mendes; Anschuetz, Lukas; Rodrigues‐Machado, Maria da Glória

doi:10.1007/s00431-021-04238-1

Cited by 7 publications

(6 citation statements)

References 37 publications

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“…This is justi ed because the increase in AP would be due to an increase in the magnitude and not in the velocity of the re ection wave. Thus, several studies have shown changes in AIx@75 without signi cant changes in PWV in children, which corroborates our ndings [13,14,18,20]. The inverse of this process occurs in older individuals, where PWV increases and AIx changes slightly, which suggests that the increase in AP would be driven by an earlier return of the re ected wave and a less compliant aorta rather than predominant changes in the magnitude of wave re ection [12,40].…”

Section: Discussionsupporting

confidence: 90%

“…Santos et al found no association between quality of life in children and adolescents and AIx@75 [13]. In contrast, Rossi-Monteiro et al showed an association between worsening quality of life in children aged 3 to 10 years with obstructive sleep-disordered breathing and an increase in PWV [14]. For the adult population, however, it has already been established that worsening in quality of life is associated with an increase in arterial stiffness rates [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, efforts have been made to nd early markers of cardiovascular disease so that timeous intervention can be carried out to reduce the development and progression of cardiovascular diseases, thus highlighting the importance of investigating arterial stiffness [11]. Possible early cardiovascular risk markers include pulse wave velocity (PWV), considered a great indicator of arterial stiffness, [12] and the augmentation index normalized to a heart rate of 75 beats per minute (AIx@75), an independent predictor of future cardiovascular events and mortality [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Changes in arterial stiffness in children and adolescents during the period of social restrictions due to the COVID-19 pandemic

Godoy-Leite

Santos

Penido

et al. 2022

Preprint

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PURPOSE: The social restrictions resulting from the COVID-19 pandemic had a great impact on the routine of children and adolescents, with important consequences such as sleep, eating, and psychological/psychiatric disorders. Even though there are no studies on the subject, it is possible that these changes in habit and routine have also affected arterial stiffness (AS) in this population, which is an important predictor of cardiovascular risk. This study aimed to assess possible changes in AS, anthropometry, and quality of life (QoL) resulting from the COVID-19 pandemic in children and adolescents. METHODS: A controlled observational cross-sectional study was performed with 193 children and adolescents aged 9 to 19 years, allocated into two groups: before the pandemic (BPG) and one year after the pandemic (APG), matched by age and sex. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device. The main AS indices evaluated were the augmentation index (AIx) and pulse wave velocity (PWV) derived from the aortic pulse wave. QoL was assessed using the Paediatric Quality of Life Inventory version 4.0 (PedsQL 4.0). RESULTS: Regarding QoL, the APG showed a worsening in emotional (p=0.002) and school-related (p=0.010) aspects. There was no statistically significant difference for most anthropometric parameters, except for the hip circumference, which was higher in the APG group (p<0.001). The main predictor of AS in the paediatric population, AIx@75, was shown to be increased in the APG group (p<0.001). Other cardiovascular parameters were also different, such as peripheral (p=0.002) and central (p=0.003) diastolic blood pressure, stroke volume (p=0.010), and total vascular resistance (p=0.002), which were shown to be decreased in the APG group, while the heart rate was increased (p<0.001). CONCLUSIONS: Our results show that routine changes resulting from the period of social isolation increased cardiovascular risk in children and adolescents, evident by the increase in AIx@75, which is considered to be an important marker of cardiovascular risk in the paediatric population.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in arterial stiffness in children and adolescents during the period of social restrictions due to the COVID-19 pandemic

Godoy-Leite

Santos

Penido

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Third, we did not collect family history data for cardiovascular disease and dietary habits; and fourth, we did not exclude participants with a history of obstructive sleep-disorder breathing. We recently demonstrated that children with obstructive sleep-disorder breathing have increased arterial stiffness, evidenced by the increase in AIx@75 [ 33 ]. Herein, we show that the factors which present a greater chance of reducing PPA in the univariate logistic regression are related to the reflection wave, reflection coefficient, augmentation pressure and AIx@75.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with arterial stiffness assessed by pulse pressure amplification in healthy children and adolescents: a cross-sectional study

et al. 2023

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Background Increasing evidence suggests that reducing pulse pressure amplification (PPA) plays an important role in pathogenesis and progression of cardiovascular disease. This is a cross-sectional, observational, and analytical study in which we evaluated the associated factors with a greater chance of reducing PPA in 136 healthy children and adolescents aged 8 to 19 years old stratified by gender and age group. Methods Arterial stiffness and vascular and hemodynamic parameters were non-invasively measured using Mobil-O-Graph® (IEM, Stolberg, Germany), a cuff-based oscillometric device. PPA was expressed as the peripheral-to-central pulse pressure ratio (PPp / PPc). Participants with PPA < 1.49 were considered as part of the arterial stiffness group. Results In a univariate model, the increase in total vascular resistance, the reflection coefficient and the augmentation pressure were more likely to have arterial stiffness in all groups. The factors most likely to have arterial stiffness (as assessed by the reduction of the PPA) in the multivariate model were increasing age, the reflection coefficient and cardiac index in the total sample, male group and child and adolescent groups. In addition to age in the female group, cardiac output, stroke volume, and AIx@75 were the factors most likely to present arterial stiffness. Conclusions The results show for the first time in children and adolescents that the factors most likely to reduce PPA are related to the reflection wave, which determines aortic pressures and, therefore, left ventricular afterload.

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“…Cardiovascular parameters were evaluated according to previous studies by our group [ 15 , 23 ]. Arterial stiffness (AS) was noninvasively estimated by measuring pulse wave velocity (PWV) and frequency-corrected augmentation index of 75 bpm (AIx@75) using the Mobil-O-Graph® device (IEM Germany - The Pulse Wave Analysis Monitor, version 4.8, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

Eating behaviour, quality of life and cardiovascular risk in obese and overweight children and adolescents: a cross-sectional study

et al. 2023

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Background Childhood obesity is a major cardiovascular risk factor because it predisposes individuals to comorbidities that are implicated in an increased risk of cardiovascular events. Its origin may be related to poor eating habits, such as the intake of foods of low nutritional value or inadequate eating behaviours related to emotional factors. This work aims to evaluate the relationship between the total body mass of children and adolescents and its association with eating habits, quality of life (QoL), and possible changes in early markers of cardiovascular risk. Methods This was a cross-sectional observational study that evaluated anthropometric and cardiovascular parameters, QoL, and eating behaviour in 181 children and adolescents aged between 5 and 13 years. Participants were stratified according to BMI/age into three groups (Adequate Weight, Overweight, and Obesity). Anthropometry included weight, height, waist and hip circumferences, waist-hip ratio, and waist-height ratio. QoL was assessed using the Peds-QL 4.0 questionnaire, and eating behaviour was assessed using the Children’s Eating Behaviour Questionnaire (CEBQ). Cardiovascular parameters were assessed using the Mobil-O-Graph® device, which measures the pulse wave velocity (PWV) and augmentation index (AIx@75) to estimate arterial stiffness (AS), which is considered an early marker of cardiovascular disease. Results In addition to the increase in anthropometric measurements (p < 0.001), the Obesity group exhibited behaviour related to food intake (p < 0.05). When analysing QoL, a worsening in the social domain was also observed in the Obesity group (p < 0.05). However, PWV and AIx@75 did not differ between groups. Conclusions Eating behaviour is related to the development of childhood obesity. However, early markers of cardiovascular risk related to AS did not change as a function of total body mass in the children evaluated.

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Pediatric obstructive sleep-disordered breathing is associated with arterial stiffness

Cited by 7 publications

References 37 publications

Changes in arterial stiffness in children and adolescents during the period of social restrictions due to the COVID-19 pandemic

Changes in arterial stiffness in children and adolescents during the period of social restrictions due to the COVID-19 pandemic

Factors associated with arterial stiffness assessed by pulse pressure amplification in healthy children and adolescents: a cross-sectional study

Eating behaviour, quality of life and cardiovascular risk in obese and overweight children and adolescents: a cross-sectional study

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