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

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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.

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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

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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.

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Authors and Affiliations

  1. Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia

    Bing Zhao, Fay H. Johnston, Marita Dalton & Kazuaki Negishi

  2. Sydney Medical School Nepean, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia

    Kazuaki Negishi

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  1. Bing Zhao
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Correspondence to Kazuaki Negishi.

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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.

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

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Zhao, B., Johnston, F.H., Dalton, M. et al. Feasibility and Normal Ranges of Arterial Intima-Media Thickness and Stiffness in 2-Year-Old Children: A Pilot Study. Pediatr Cardiol 40, 914–920 (2019). https://doi.org/10.1007/s00246-019-02088-1

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