The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese
Ramy El Jalbout1, Guy Cloutier2, Marie-Hélène Roy-Cardinal2
1Department of Radiology, Sainte Justine Hospital, University of Montreal, 3175 Cote-Sainte-Catherine Road, Montreal, Quebec, H3T 1C5, Canada. ramy.el-jalbout.hsj@ssss.gouv.qc.ca.
Insights
Non-invasive vascular elastography (NIVE) detects early arterial changes in obese children. This technique shows promise for monitoring subclinical atherosclerosis risk in pediatric populations.
Area of Science:
- Vascular Ultrasound
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Childhood obesity is a growing concern linked to early cardiovascular disease.
- Subclinical atherosclerosis markers in children require non-invasive detection methods.
- Non-invasive vascular elastography (NIVE) assesses arterial wall mechanics.
Purpose of the Study:
- To evaluate NIVE's efficacy in identifying vascular changes in obese children.
- To compare carotid artery elastography parameters between children with and without elevated BMI.
- To assess NIVE's potential for detecting subclinical atherosclerosis.
Main Methods:
- A case-control study involving 120 children (60 with elevated BMI).
- Radiofrequency ultrasound of the common carotid artery analyzed using NIVE.
- Measurement of parameters including cumulated axial strain (CAS), cumulated axial translation (CAT), and intima-media thickness (IMT).
- Multivariate analyses controlled for age, sex, Tanner stage, blood pressure, and LDL.
Main Results:
- Children with elevated BMI exhibited significantly higher CAT (0.68 mm vs. 0.52 mm, p<0.001).
- Elevated BMI group showed a significantly lower CAS/CAT ratio (9.54 vs. 13.34, p=0.001).
- Intima-media thickness was higher in the elevated BMI group (0.36 mm vs. 0.32 mm, p=0.013).
Conclusions:
- NIVE effectively detected differences in CAT and CAS/CAT in children with elevated BMI.
- NIVE shows promise as a tool for monitoring radiological markers of subclinical atherosclerosis.
- These findings aid in stratifying children at risk for atherosclerosis and guiding preventive strategies.
Objectives:
Evaluate non-invasive vascular elastography (NIVE) in detecting vascular changes associated with obese children.
Methods:
Case-control study to evaluate NIVE in 120 children, 60 with elevated body mass index (BMI) (≥ 85th percentile for age and sex). Participants were randomly selected from a longitudinal cohort, evaluating consequences of obesity in healthy children with one obese parent. Radiofrequency ultrasound videos of the common carotid artery were obtained. The carotid wall was segmented and NIVE applied to measure cumulated axial strain (CAS), cumulated axial translation (CAT), cumulated lateral translation (CLT), maximal shear strain (Max |SSE|), and intima-media thickness (IMT). Multivariate analyses were used controlling for age, sex, Tanner stage, blood pressure, and low-density lipoprotein. Statistical significance was set to 0.05-0.008. Participants were 10-13 years old (mean 11.4 and 12.0, for normal and elevated BMI groups, p < 0.001), 58% and 63% boys, respectively. Groups differed in age, Tanner stage, and blood pressure. In the normal BMI group, there was weak correlation between systolic blood pressure and Max |SSE| (r = 0.316, p = 0.01) and weak correlation between pulse pressure and Max |SSE| (r = 0.259, p = 0.045). After Bonferroni correction, CAT was significantly higher in the elevated BMI group (0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm), p < 0.001. CAS/CAT was significantly lower in the elevated BMI group (9.54 ± 4.8 vs. 13.34 ± 6.46), p = 0.001. IMT was significantly higher in the elevated BMI group (0.36 ± 0.05 mm vs. 0.32 ± 0.05 mm) before Bonferroni correction, p = 0.013.
Conclusions:
NIVE detected differences in CAT and CAS/CAT in elevated BMI children. NIVE is a promising technique to monitor radiological markers of subclinical atherosclerosis.
Key Points:
• NIVE is a non-invasive technique based on measurement of subsegmental focal deformation of vascular wall to detect subclinical changes in arterial wall compliance. • Children with elevated BMI showed increased carotid artery wall movement during systole, as compared to normal BMI children (mean 0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm; p < 0.001) and a lower ratio of vascular wall strain to wall movement during systole (mean 9.54 ± 4.8 vs. 13.34 ± 6.46; p = 0.001). • The detection of these subclinical changes helps physicians in the stratification of children at risk of atherosclerosis and guides in the implementation of preventive measures.
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