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Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Endothelial function evaluated by flow-mediated dilatation in pediatric vascular disease
T Kadono1, H Sugiyama, M Hoshiai
1Department of Pediatrics, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, 409-3898, Tamaho, Japan.
Insights
Endothelial dysfunction, measured by flow-mediated dilatation (FMD), is present in children with Kawasaki disease (KD) and diabetes mellitus (DM). This impairment precedes intima-media thickening, aiding in predicting vascular complications.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Endocrinology
Background:
- Endothelial dysfunction is an early indicator of cardiovascular disease.
- Kawasaki disease (KD) and diabetes mellitus (DM) are significant pediatric conditions affecting vascular health.
Purpose of the Study:
- To assess endothelial function in children with KD and DM compared to healthy controls.
- To investigate the relationship between flow-mediated dilatation (FMD) and intima-media complex thickness in these pediatric populations.
Main Methods:
- Flow-mediated dilatation (FMD) and intima-media complex of the common carotid artery were measured in 41 controls, 24 with KD, and 46 with DM.
- Participants ranged from 3 to 23 years old.
- Data were analyzed to compare FMD and intima-media complex across groups and within subgroups (e.g., KD with/without aneurysm, DM with high/normal HbA1c).
Main Results:
- FMD was significantly reduced in children with KD and DM compared to controls.
- No significant difference in intima-media complex was observed among the groups.
- FMD was lower in KD patients with coronary arterial aneurysms and in DM patients with higher HbA1c levels.
Conclusions:
- Endothelial impairment, detected by reduced FMD, is evident in children with KD or type 1 DM, even without overt vascular complications.
- FMD impairment occurs before significant changes in intima-media complex thickness.
- Measuring both FMD and intima-media complex may offer valuable insights for predicting future vascular complications in children.
Abstract:
The endothelial function of children with and without vascular disease, consisting of 41 controls, 24 with Kawasaki disease (KD), and 46 with diabetes mellitus (DM), was examined. Age at examination ranged from 3 to 23 years (mean, 12.0 +/- 4.7). The flow-mediated dilatation (FMD) and intima-media complex in the common carotid artery were measured. In controls age at examination was not associated with FMD or intima-media complex. FMD significantly decreased in children with KD and DM compared with the control group (control vs KD or DM: 11.7 +/- 14.7 vs 3.0 +/- 11.0 or 6.4 +/- 8.5%, respectively; p < 0.05). However, there was no significant difference for intima-media complex among the groups. Furthermore, FMD in KD patients with coronary arterial aneurysm was lower than that in KD patients without aneurysm (-0.5 +/- 9.2 vs 8.3 +/- 9.1%, p < 0.05). In DM patients, FMD in the high HbA1c group (HbA1c = 7%) was lower than that in the normal HbA1c group (HbA1c < 7%) (4.8 +/- 8.1 vs 11.4 +/- 7.8%, p < 0.05). In conclusion, FMD detected endothelial impairment in children with KD or type 1 DM regardless of overt vascular complications, and FMD impairment occurs prior to intima-media complex thickening. By measuring both FMD and intima-media complex, useful information for predicting vascular complications may be obtained.
