학술논문
Wall Properties of Elastic and Muscular Arteries in Children and Adolescents at Increased Cardiovascular Risk.
Document Type
Academic Journal
Author
Genovesi S; Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy.; School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.; Tassistro E; School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.; Lieti G; School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.; Patti I; School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.; Giussani M; Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy.; Antolini L; School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.; Orlando A; Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy.; Salvi P; Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy.; Parati G; Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy.; School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
Background: Pulse wave velocity (PWV) assessment represents a simple method to estimate arterial distensibility. At present, carotid-femoral PWV (cf-PWV) is considered the gold standard method in the non-invasive evaluation of the elastic properties of the aorta. On the other hand, the mechanical properties of muscular arteries can be evaluated on the axillo-brachial-radia axis by estimating the carotid-radial PWV (cr-PWV). While a number of studies have addressed these issues in adults, limited information is available on the respective features of cf-PWV and cr-PWV and on their modulating factors in children and adolescents at increased cardiovascular risk.
Methods: The mechanical properties of the predominantly elastic (aorta) and muscular (axillo-brachial-radial axis) arteries were evaluated in a pediatric population characterized by either elevated blood pressure (BP) or excess body weight, and the main factors affecting cf-PWV and cr-PWV values in these individuals were investigated.
Results: 443 children and adolescents (median age 11.5 years, 43.3% females) were enrolled; 25% had BP values >90th percentile and 81% were excess weight. The cf-PWV values were significantly lower than the cr-PWV values: median (Q1-Q3) = 4.8 m/s (4.3-5.5) and 5.8 m/s (5.0-6.5), respectively ( p < 0.001). The pubertal development ( p < 0.03), systolic BP and diastolic BP z-scores ( p = 0.002), heart rate ( p < 0.001), and waist-to-height ratio ( p < 0.005) were significantly associated with cf-PWV values. No significant association was found between BMI z-score and cf-PWV. Predictors of high cf-PWV (>95th percentile) were the heart rate (OR 1.07, 95%CI 1.04-1.10, p < 0.001) and waist-to-height ratio (OR 1.06, 95%CI 1.0-1.13, p = 0.04). The variables significantly related with cr-PWV values were diastolic BP z-score ( p = 0.001), heart rate ( p < 0.01), and HOMA index ( p < 0.02). No significant association was found between the cr-PWV and BMI z-score or waist-to-height ratio.
Conclusions: Systolic and diastolic BP values and central obesity are associated with aortic stiffness in a population of children and adolescents at increased cardiovascular risk. In contrast, diastolic BP, heart rate, and levels of insulin resistance appear to be related to distensibility of the upper limb vascular district.
Methods: The mechanical properties of the predominantly elastic (aorta) and muscular (axillo-brachial-radial axis) arteries were evaluated in a pediatric population characterized by either elevated blood pressure (BP) or excess body weight, and the main factors affecting cf-PWV and cr-PWV values in these individuals were investigated.
Results: 443 children and adolescents (median age 11.5 years, 43.3% females) were enrolled; 25% had BP values >90th percentile and 81% were excess weight. The cf-PWV values were significantly lower than the cr-PWV values: median (Q1-Q3) = 4.8 m/s (4.3-5.5) and 5.8 m/s (5.0-6.5), respectively ( p < 0.001). The pubertal development ( p < 0.03), systolic BP and diastolic BP z-scores ( p = 0.002), heart rate ( p < 0.001), and waist-to-height ratio ( p < 0.005) were significantly associated with cf-PWV values. No significant association was found between BMI z-score and cf-PWV. Predictors of high cf-PWV (>95th percentile) were the heart rate (OR 1.07, 95%CI 1.04-1.10, p < 0.001) and waist-to-height ratio (OR 1.06, 95%CI 1.0-1.13, p = 0.04). The variables significantly related with cr-PWV values were diastolic BP z-score ( p = 0.001), heart rate ( p < 0.01), and HOMA index ( p < 0.02). No significant association was found between the cr-PWV and BMI z-score or waist-to-height ratio.
Conclusions: Systolic and diastolic BP values and central obesity are associated with aortic stiffness in a population of children and adolescents at increased cardiovascular risk. In contrast, diastolic BP, heart rate, and levels of insulin resistance appear to be related to distensibility of the upper limb vascular district.