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Feasibility and Normal Ranges of Arterial Intima-Media Thickness and Stiffness in 2-Year-Old Children: A Pilot Study
Bing Zhao1, Fay H Johnston1, Marita Dalton1
1Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia.
Insights
Noninvasive vascular assessments are feasible in two-thirds of 2-year-olds, with carotid intima-media thickness (cIMT) showing better results. This study establishes normal vascular function ranges for early cardiovascular risk detection in young children.
Area of Science:
- Pediatric cardiology
- Vascular biology
- Noninvasive diagnostic techniques
Background:
- Established noninvasive vascular function assessments exist for adults.
- Limited data on applicability and reference values in children under 6 years old, especially under 2.
- Need to determine feasibility and normal ranges for 2-year-olds.
Purpose of the Study:
- Assess feasibility of noninvasive vascular assessments in 2-year-old children.
- Determine normal reference values for vascular parameters in this age group.
Main Methods:
- Evaluated carotid intima-media thickness (cIMT), abdominal aorta IMT (aaIMT), pulse wave velocity (PWV), arterial diameter change, stiffness index (β), and distensibility in 2-year-olds.
- Utilized automatic contour detection for IMT measurements.
Main Results:
- Successful measurements achieved in 72% of children (cIMT 64%, aaIMT 67%, PWV 43%).
- Average far wall cIMT was 0.51 mm, aaIMT was 0.40 mm, and mean PWV was 4.15 m/s.
- Carotid arteries showed higher distensibility (4.58%/10 mmHg) than the abdominal aorta (2.98%/10 mmHg). cIMT yielded better image quality and feasibility than aaIMT.
- PWV measurement was feasible only in cooperative children.
Conclusions:
- Noninvasive cardiovascular risk detection methods are feasible in at least two-thirds of 2-year-old children.
- Carotid intima-media thickness (cIMT) is a preferable method due to higher feasibility and better image quality for assessing vascular health in young children.
Introduction:
In adults, noninvasive assessments of vascular function have been established. However, little is known about the applicability and reference values of these techniques among children < 6 years old and none ≤ 2. We aimed to determine the feasibility of conducting noninvasive vascular assessments in 2-year-old children and the normal range of results in this age group.
Methods:
Carotid intima-media thickness (cIMT) and abdominal aorta IMT (aaIMT), pulse wave velocity (PWV), arterial diameter change, stiffness index (β), and distensibility were assessed in 2-year-old children. IMT was assessed using an automatic contour detection.
Results:
The proportion of successful measurements was 72% (42/58) with cIMT 64%, aaIMT 67%, and PWV 43%. Average far wall cIMT was 0.51 mm and 0.40 for aaIMT. Mean PWV was 4.15 m/s, with relatively wider range in stiffness index and distensibility. Common carotid arteries had a higher mean distensibility of 4.58%/10 mmHg compared with 2.98%/10 mmHg for the abdominal aorta. The number of data points automatically detected at far wall cIMT was higher than that in aaIMT (left cIMT: 244 ± 13 and right: 240 ± 23 vs. abdominal 185 ± 63, p < 0.001). Better and more consistent quality was achieved for cIMT than aaIMT measurements. PWV measurement was only feasible in cooperative children with efficient distractions.
Conclusions:
Noninvasive methods for early detection of cardiovascular risks were feasible in at least two-thirds of 2-year-old children. Given the greater feasibility and image quality, cIMT is a preferable option for assessing vascular health in young children.
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