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Published on: June 22, 2012
Endothelial-dependent vasodilation is impaired in children with sickle cell disease
Mariane de Montalembert1, Yacine Aggoun, Assa Niakate
1Service de Pédiatrie Générale, Hôpital Necker, Paris, France. mariane.demontal@nck.aphp.fr
Insights
Endothelial dysfunction, a blood vessel issue, is present in children with sickle cell anemia (SCA). This early impairment of vasodilation suggests potential long-term vascular complications in pediatric SCA patients.
Area of Science:
- Pediatric vascular health
- Hematology
- Cardiovascular research
Background:
- Endothelial-dependent vasodilation is impaired in adult sickle cell anemia (SCA) patients.
- Early vascular changes in pediatric SCA are not well understood.
Purpose of the Study:
- To investigate endothelial function in children with SCA.
- To compare brachial artery vasodilation and carotid artery structure in SCA children and controls.
Main Methods:
- Echotracking was used to assess flow-mediated dilation (FMD) and nitroglycerine-mediated dilation (GTNMD) of the brachial artery.
- Intima-media thickness (IMT) and mechanical properties of the common carotid artery were measured.
- Study included 21 SCA children and 23 healthy Afro-Caribbean controls.
Main Results:
- SCA children exhibited significantly decreased FMD compared to controls (5.6% vs 8.0%, p=0.008).
- No significant differences were observed in IMT, carotid artery stiffness, or GTNMD between groups.
- These findings indicate early endothelial dysfunction in pediatric SCA.
Conclusions:
- Endothelial dysfunction is detectable in children with sickle cell anemia.
- This suggests that vascular complications may begin in early childhood for SCA patients.
- Early identification of endothelial dysfunction is crucial for managing pediatric SCA.
Abstract:
Impairment of endothelial-dependent vasodilation has been demonstrated in adults with sickle cell anemia (SCA). We enrolled 21 SCA children, mean age 10.4+/-3.3 yrs, and 23 Afro-Caribbean controls. We examined flow-mediated (FMD) and nitroglycerine-mediated (GTNMD) dilation of the brachial artery, using echotracking techniques, and measured intima-media thickness (IMT) and mechanical properties of the common carotid artery. FMD was significantly decreased in SCA children vs controls (5.6+/-0.2 vs 8.0+/-0.2%, p=0.008), while IMT, stiffness of the common carotid artery, and GTNMD were comparable. In conclusion, endothelial dysfunction is present as early as childhood in SCA patients.
