Feasibility and Normal Ranges of Arterial Intima-Media Thickness and Stiffness in 2-Year-Old Children: A Pilot Study
In adults, noninvasive assessments of vascular function have been established. However, little is known about the applicability and reference values of these techniques among children < 6 years old and none ≤ 2. We aimed to determine the feasibility of conducting noninvasive vascular assessments in 2-year-old children and the normal range of results in this age group.
Carotid intima-media thickness (cIMT) and abdominal aorta IMT (aaIMT), pulse wave velocity (PWV), arterial diameter change, stiffness index (β), and distensibility were assessed in 2-year-old children. IMT was assessed using an automatic contour detection.
The proportion of successful measurements was 72% (42/58) with cIMT 64%, aaIMT 67%, and PWV 43%. Average far wall cIMT was 0.51 mm and 0.40 for aaIMT. Mean PWV was 4.15 m/s, with relatively wider range in stiffness index and distensibility. Common carotid arteries had a higher mean distensibility of 4.58%/10 mmHg compared with 2.98%/10 mmHg for the abdominal aorta. The number of data points automatically detected at far wall cIMT was higher than that in aaIMT (left cIMT: 244 ± 13 and right: 240 ± 23 vs. abdominal 185 ± 63, p < 0.001). Better and more consistent quality was achieved for cIMT than aaIMT measurements. PWV measurement was only feasible in cooperative children with efficient distractions.
Noninvasive methods for early detection of cardiovascular risks were feasible in at least two-thirds of 2-year-old children. Given the greater feasibility and image quality, cIMT is a preferable option for assessing vascular health in young children.
KeywordsIntima-media thickness Pulse wave velocity Arterial stiffness Children
Abdominal aorta intima-media thickness
Association for European Paediatric Cardiology
Body mass index
Carotid intima-media thickness
Diastolic blood pressure
European Society of Cardiology
European Society of Hypertension
Mean arterial pressure
Pulse wave velocity
Systolic blood pressure
Artery stiffness index
The authors acknowledge the participants and their guardians of Latrobe Early Life Follow-Up Study. We would like to thank Ms. Melanie Reeves, Ms. Susan Denny, Ms. Krissi Creighton, Ms. Kylie Sawyer and Ms. Emerson Easley with preparing and assisting the clinical assessment, and the Hazelwood Health Study research team for their contributions to this study.
This study was funded by the Victorian Department of Health and Human Services. The report presents the views of the authors and does not represent the views of the Department.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
Tasmanian Health and Medical Human Research Ethics Committee approved the study protocol (Ethics Reference Number: H0014875), which also conforms to the ethical guidelines of the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from all guardians of the individual participants included in the study.
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