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Published on: February 7, 2014
Aortic Pulse Wave Velocity in Healthy Children and Adolescents: Reference Values for the Vicorder Device and
Daniela Thurn1, Anke Doyon2, Betul Sözeri3
1Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany;
Insights
This study establishes normal pulse wave velocity (PWV) values for children using the Vicorder device. It identifies key predictors and risk factors for arterial stiffness in healthy youth, aiding future cardiovascular risk assessment.
Area of Science:
- Pediatric Cardiology
- Vascular Physiology
- Biomedical Engineering
Background:
- Aortic pulse wave velocity (PWV) indicates arterial stiffness and predicts cardiovascular mortality in adults.
- Arterial stiffening accelerates with age and in pediatric conditions like chronic kidney disease or diabetes.
- Reference values for the Vicorder device in children and its association with carotid stiffness and risk factors are not well-established.
Purpose of the Study:
- To establish gender-specific reference values for aortic PWV in healthy children and adolescents using the Vicorder device.
- To investigate the association between PWV and carotid stiffness parameters.
- To identify individual and family risk factors influencing PWV in a pediatric population.
Main Methods:
- 1,003 healthy children (6-18 years) had PWV measured using the Vicorder device across 6 centers.
- Carotid distensibility and intima media thickness were assessed in 589 children.
- Gestational and family history data were collected.
Main Results:
- PWV showed significant correlations with age, gender, height, weight, BMI, blood pressure, pulse pressure, and heart rate.
- Independent predictors of PWV included gender, age, height, weight, mean arterial pressure, and heart rate.
- Risk factors for elevated PWV included being small for gestational age, secondhand smoke exposure, parental hypertension, and obesity.
Conclusions:
- This study provides crucial reference values for Vicorder-derived PWV in children and adolescents.
- Associations between PWV and cardiovascular risk factors in a healthy pediatric population were identified.
- Gender-specific age/height percentiles enable better assessment of pediatric cohorts using this oscillometric method.
Background:
Aortic pulse wave velocity (PWV), an indicator of arterial stiffness, independently predicts cardiovascular mortality risk in adults. Arterial stiffening advances with age and seems accelerated in children with certain disease conditions such as chronic kidney disease or diabetes. The Vicorder, an oscillometric device to measure PWV, has been validated in children, but reference values in a large pediatric cohort, association to carotid stiffness and influence of individual and family risk factors have not been determined.
Methods:
Pulse waves were captured in 1,003 healthy children (aged 6-18 years) in 6 centers and gender-specific reference data normalized to age/height were constructed. In 589 children carotid distensibility and intima media thickness were measured. Gestational and family history was reported.
Results:
PWV correlated with age (r = 0.57, P < 0.0001) with significant gender-related differences starting at age 9. Further significant correlations were seen for height, weight, body mass index, blood pressure, pulse pressure, and heart rate. Independent predictors for PWV in a multivariate regression analysis were gender, age, height, weight, mean arterial pressure, and heart rate. Risk factors for higher PWV included small for gestational age at birth, secondhand smoking, parental hypertension, and obesity. PWV showed weak correlations with 2 of the carotid distensibility measures, but not with intima media thickness.
Conclusion:
This study defines reference values for PWV captured by the Vicorder device in children and adolescents and reveals associations with potential cardiovascular risk factors in a healthy population. Gender-specific percentiles for age/height will allow for the assessment of pediatric cohorts using this oscillometric method.
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