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The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese children

  • Paediatric
  • Published:
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Abstract

Objectives

Evaluate non-invasive vascular elastography (NIVE) in detecting vascular changes associated with obese children.

Methods

Case-control study to evaluate NIVE in 120 children, 60 with elevated body mass index (BMI) (≥ 85th percentile for age and sex). Participants were randomly selected from a longitudinal cohort, evaluating consequences of obesity in healthy children with one obese parent. Radiofrequency ultrasound videos of the common carotid artery were obtained. The carotid wall was segmented and NIVE applied to measure cumulated axial strain (CAS), cumulated axial translation (CAT), cumulated lateral translation (CLT), maximal shear strain (Max |SSE|), and intima-media thickness (IMT). Multivariate analyses were used controlling for age, sex, Tanner stage, blood pressure, and low-density lipoprotein. Statistical significance was set to 0.05–0.008. Participants were 10–13 years old (mean 11.4 and 12.0, for normal and elevated BMI groups, p < 0.001), 58% and 63% boys, respectively. Groups differed in age, Tanner stage, and blood pressure. In the normal BMI group, there was weak correlation between systolic blood pressure and Max |SSE| (r = 0.316, p = 0.01) and weak correlation between pulse pressure and Max |SSE| (r = 0.259, p = 0.045). After Bonferroni correction, CAT was significantly higher in the elevated BMI group (0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm), p < 0.001. CAS/CAT was significantly lower in the elevated BMI group (9.54 ± 4.8 vs. 13.34 ± 6.46), p = 0.001. IMT was significantly higher in the elevated BMI group (0.36 ± 0.05 mm vs. 0.32 ± 0.05 mm) before Bonferroni correction, p = 0.013.

Conclusions

NIVE detected differences in CAT and CAS/CAT in elevated BMI children. NIVE is a promising technique to monitor radiological markers of subclinical atherosclerosis.

Key Points

• NIVE is a non-invasive technique based on measurement of subsegmental focal deformation of vascular wall to detect subclinical changes in arterial wall compliance.

• Children with elevated BMI showed increased carotid artery wall movement during systole, as compared to normal BMI children (mean 0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm; p < 0.001) and a lower ratio of vascular wall strain to wall movement during systole (mean 9.54 ± 4.8 vs. 13.34 ± 6.46; p = 0.001).

• The detection of these subclinical changes helps physicians in the stratification of children at risk of atherosclerosis and guides in the implementation of preventive measures.

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Abbreviations

ANOVA:

Analysis of variance

BMI:

Body mass index

CAS:

Cumulated axial strain

CAT:

Cumulated axial translation

CLT:

Cumulated lateral translation

IMT:

Intima-media thickness

LDL:

Low-density lipoprotein

Max |SSE|:

Maximal shear strain

NIVE:

Non-invasive vascular elastography

PWV:

Pulse wave velocity

RF:

Radiofrequency

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Acknowledgements

The authors are grateful to Danielle Buch, medical writer, for critical revision and substantive editing of the entire manuscript, also including drafting of Abstract.

Funding

This study was partially funded by NSERC CHRP 462240-14, CIHR CPG-134748.

Author information

Authors and Affiliations

  1. Department of Radiology, Sainte Justine Hospital, University of Montreal, 3175 Cote-Sainte-Catherine Road, Montreal, Quebec, H3T 1C5, Canada

    Ramy El Jalbout, Chantale Lapierre & Josée Dubois

  2. Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada

    Guy Cloutier & Marie-Hélène Roy-Cardinal

  3. Department of Pediatrics, Sainte Justine Hospital, University of Montreal, Montreal, Quebec, Canada

    Mélanie Henderson & Emile Levy

  4. Department of Radiology, University of Montreal Hospital (CHUM), Montreal, Quebec, Canada

    Gilles Soulez

Authors
  1. Ramy El Jalbout
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  2. Guy Cloutier
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  3. Marie-Hélène Roy-Cardinal
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  4. Mélanie Henderson
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  5. Emile Levy
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  6. Chantale Lapierre
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  7. Gilles Soulez
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  8. Josée Dubois
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Corresponding author

Correspondence to Ramy El Jalbout.

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Guarantor

The scientific guarantor of this publication is Dr. Josee Dubois.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Mr. Thierry Ducruet, CHU Sainte-Justine, kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Ste-Justine Hospital Ethics Review Board

Quebec Lung and Heart Institute

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in the QUALITY study (Quebec Adipose and Lifestyle InvesTigation in Youth) and in the article Carotid artery intima-media thickness measurement in children with normal and increased body mass index: A comparison of three techniques (Pediatric Radiology, August 2018, vol 48, issue 8, pages 1073-1079.

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El Jalbout, R., Cloutier, G., Roy-Cardinal, MH. et al. The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese children. Eur Radiol 29, 3854–3861 (2019). https://doi.org/10.1007/s00330-019-06051-9

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  • DOI: https://doi.org/10.1007/s00330-019-06051-9

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