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Peripheral and Central Aortic Pressure, Wave-Derived Reflection Parameters, Local and Regional Arterial Stiffness and Structural Parameters in Children and Adolescents: Impact of Body Mass Index Variations

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Abstract

Aim

The aim was to analyze and compare the associations between body mass index (BMI) and structural and functional cardiovascular variables measured in children and adolescents.

Methods

609 healthy subjects (mean age/range 12/4–18 years, 45% females) were studied. Subjects’ BMI and the corresponding z-scores (z-BMI) were determined. Cardiovascular measurements: peripheral and aortic blood pressure (BP), aortic wave-derived parameters, common carotid, femoral and brachial artery diameters and stiffness, carotid intima–media thickness, carotid-radial and carotid-femoral pulse wave velocity (crPWV, cfPWV) and cfPWV/crPWV ratio. Cardiovascular data were standardized (z-scores) using equations (fractional polynomials) obtained from a sub-group (reference population, n = 241) non-exposed to cardiovascular risk factors (CVRFs). Simple and multiple regression models were obtained for the associations between cardiovascular z-scores and z-BMI and/or z-BMI, age, sex and CVRFs.

Results

z-BMI was associated with standardized cardiovascular variables, regardless of age, sex and CVRFs. BP (peripheral rather than aortic) was the variable with the greatest variations associated with z-BMI. Systolic (SBP) and pulse pressure (PP; in that order) were the variables with the highest variations associated with z-BMI. Carotid, but not femoral or brachial stiffness showed BP-dependent variations associated with z-BMI. Arterial diameters were associated with z-BMI, without differences among arteries.

Conclusion

In children and adolescents, z-BMI was gradually and positively associated with haemodynamic (peripheral and central BP) and vascular parameters (structural and functional) with independence of age, sex and other CVRFs (Dyslipidemia, Hypertension, Smoke, Diabetes). There were differences in the associations depending on the arteries studied and on whether central or peripheral haemodynamic parameters were analyzed.

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Author notes

  1. Victoria Garcia-Espinosa, Daniel Bia and Yanina Zócalo contributed equally to this work.

Authors and Affiliations

  1. Physiology Department, Faculty of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay

    Victoria Garcia-Espinosa, Daniel Bia, Juan Castro, Agustina Zinoveev, Mariana Marin & Yanina Zócalo

  2. Pediatric Clinic, Faculty of Medicine, Pereira-Rossell Hospital, Republic University, Bulevar Artigas 1550, 11600, Montevideo, Uruguay

    Gustavo Giachetto

  3. Pediatric Cardiology Service, Pereira-Rossell Hospital, Bulevar Artigas 1550, 11600, Montevideo, Uruguay

    Pedro Chiesa

Authors
  1. Victoria Garcia-Espinosa
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  2. Daniel Bia
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  3. Juan Castro
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  4. Agustina Zinoveev
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  5. Mariana Marin
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  6. Gustavo Giachetto
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  7. Pedro Chiesa
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  8. Yanina Zócalo
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Corresponding author

Correspondence to Daniel Bia.

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Funding

This study was funded by the Agencia Nacional de Investigación e Innovación, Espacio Interdisciplinario and Comisión Sectorial de Investigación Científica of the Republic University, Uruguay. Additionally, was supported by extrabudgetary funds generated by CUiiDARTE-Centre. None of these organizations influenced the study design or collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the manuscript for publication.

Conflict of Interest

Victoria Garcia-Espinosa declares she has no conflict of interest. Daniel Bia declares he has no conflict of interest. Juan Castro declares he has no conflict of interest. Agustina Zinoveev declares she has no conflict of interest. Mariana Marin declares she has no conflict of interest. Gustavo Giachetto declares he has no conflict of interest. Pedro Chiesa, declares he has no conflict of interest. Yanina Zócalo declares she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual (or guardians).

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Garcia-Espinosa, V., Bia, D., Castro, J. et al. Peripheral and Central Aortic Pressure, Wave-Derived Reflection Parameters, Local and Regional Arterial Stiffness and Structural Parameters in Children and Adolescents: Impact of Body Mass Index Variations. High Blood Press Cardiovasc Prev 25, 267–280 (2018). https://doi.org/10.1007/s40292-018-0264-1

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  • DOI: https://doi.org/10.1007/s40292-018-0264-1

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