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Feasibility and Normal Ranges of Arterial Intima-Media Thickness and Stiffness in 2-Year-Old Children: A Pilot Study

  • Bing Zhao
  • Fay H. Johnston
  • Marita Dalton
  • Kazuaki NegishiEmail author
Original Article

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Intima-media thickness Pulse wave velocity Arterial stiffness Children 

Abbreviations

aaIMT

Abdominal aorta intima-media thickness

AEPC

Association for European Paediatric Cardiology

Ave

Average

BP

Blood pressure

BMI

Body mass index

cIMT

Carotid intima-media thickness

CVD

Cardiovascular disease

DBP

Diastolic blood pressure

Dist

Distensibility

Dmax

End-systolic diameter

Dmin

End-diastolic diameter

ECG

Electrocardiograph

ESC

European Society of Cardiology

ESH

European Society of Hypertension

IMT

Intima-media thickness

IQR

Interquartile range

MAP

Mean arterial pressure

Max

Maximum

Min

Minimum

Pts

Points

PP

Pulse pressure

PWV

Pulse wave velocity

SBP

Systolic blood pressure

β

Artery stiffness index

Notes

Acknowledgements

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.

Funding

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.

Ethical Approval

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

Informed consent was obtained from all guardians of the individual participants included in the study.

Supplementary material

246_2019_2088_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 32 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Menzies Institute for Medical ResearchUniversity of TasmaniaHobartAustralia
  2. 2.Sydney Medical School Nepean, Charles Perkins Centre Nepean, Faculty of Medicine and HealthThe University of SydneySydneyAustralia

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