Beyond intima-media-thickness: Analysis of the carotid intima-media-roughness in a paediatric population
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Published on: September 27, 2024
Robert Dalla Pozza1, Raphael Pirzer1, Andreas Beyerlein2
1Department of Pediatric Cardiology, Ludwig Maximilians-University of Munich, Marchioninistr. 15, D-81377 Munich, Germany.
Insights
This study establishes normal values for carotid intima-media roughness (cIMR) in children, a new marker for cardiovascular risk. These findings help identify at-risk youth and improve early detection of potential heart disease.
Area of Science:
- Cardiology
- Pediatrics
- Medical Imaging
Background:
- Subclinical atherosclerosis, indicated by carotid intima-media thickness (cIMT), is an early cardiovascular disease precursor.
- Carotid intima-media roughness (cIMR) analysis enhances cardiovascular risk profiling in adults and is elevated in at-risk children.
- Normative data for cIMR in pediatric populations are currently lacking.
Purpose of the Study:
- To present normative data for carotid intima-media roughness (cIMR) in a healthy pediatric age group.
- To establish reference values for cIMR across different pediatric age ranges.
- To assess the potential of cIMR in improving cardiovascular risk stratification in children.
Main Methods:
- 602 healthy German school children aged 8-18 years were studied.
- Carotid intima-media thickness (cIMT) and carotid intima-media roughness (cIMR) were calculated using sonography.
- Reference values were determined for three age groups: 8-10.99 years, 11-13.99 years, and 14-17.99 years.
Main Results:
- Normal cIMT values were established for the pediatric age groups.
- Normal cIMR values were determined: 0.04 ± 0.01 mm for age groups 1 and 3, and 0.03 ± 0.01 mm for age group 2.
- Physical fitness showed a significant negative correlation with cIMR (r = -0.212, p < 0.0001), indicating it's a predictor of increased cIMR.
Conclusions:
- The presented normative cIMR data enable the identification of pediatric patients at elevated cardiovascular risk.
- Incorporating cIMR analysis of the arterial wall can improve individual risk stratification compared to cIMT alone, even in pediatric patients.
- This study provides essential reference values for cIMR in children, aiding in early cardiovascular risk assessment.
Background And Aims:
Subclinical atherosclerosis assessed by sonographic intima-media-thickness measurement of the carotid artery (cIMT) is considered to be an early precursor of cardiovascular disease already in childhood. Structural analysis of the carotid intimal layer (carotid intima-media-roughness, cIMR) improves cardiovascular risk profiling for the adult patient and has been shown to be increased also in paediatric patients with elevated cardiovascular risk. To date, normal values for the paediatric age are lacking. Thus, we present normative data for a paediatric age group.
Methods:
602 healthy German school children (age 8-18 y) were studied, and cIMT and cIMR calculated; reference values were given for three age groups (group 1: 8-10.99 years; group 2: 11-13.99 years; group 3: 14-17.99 years).
Results:
cIMT values were: 0.48 ± 0.03 mm for girls and boys in age group 1, 0.49 ± 0.03 mm for girls and boys in age group 2; and 0.45 ± 0.03 mm for girls and 0.49 ± 0.03 mm for boys in age group 3; cIMR was 0.04 ± 0.01 mm for both sexes in age group 1 and 3; while in age group 2, both sexes showed a cIMR of 0.03 ± 0.01 mm. Physical fitness was significantly negatively correlated with cIMR (r = - 0.212, p < 0.0001) and a strong predictor for cIMR increase.
Conclusions:
The normative data of cIMR for a paediatric age group presented here allow for the identification of patients at elevated cardiovascular risk. By including cIMR as surface analysis of the arterial wall, the individual risk stratification may be improved compared to thickness-analysis of the Intima-Media-Layer (cIMT) also at a paediatric age.
