Brachial-femoral pulse wave velocity in 2-4-year-old children: a feasibility study

Cardiovascular disease (CVD) progression occurs across the lifespan. However, available measures of CVD risk in young children are limited. Carotid-femoral pulse wave velocity (cfPWV) is a gold-standard, noninvasive measure of CVD risk that has been studied in children ages 6-18 years. Yet, cfPWV has been measured to a lesser extent in younger children, a population whose temperament or attention span may pose unique challenges. Brachial-femoral PWV (bfPWV) may be feasible, more acceptable, and could provide similar CVD risk assessment to cfPWV in younger children. This study aimed to determine the feasibility of bfPWV measurement in children ages 2-4 years including assessment of comparability of bfPWV to cfPWV normative data.

In 10 children (mean 2.9 ± 0.5 years), oscillometric cuffs were placed on the upper thigh and upper arm. Following a 5-min rest, cuffs were inflated to a subdiastolic pressure three times, and waveforms were captured. Procedures were repeated after a 15-min rest. Measured values were compared to age-predicted cfPWV extrapolated from published normative data in children 6-18 years of age.

We successfully obtained at least one acceptable quality bfPWV scan in all participants. Among the subset with a repeated measurement ( n = 5), mean (SD) difference between measurements was 0.013 (0.28) m/s. Mean bfPWV was slightly higher than age-predicted cfPWV (observed: 4.55 m/s; predicted: 3.99 m/s; P = 0.012) with larger residuals among younger children and those not reclined in a chair during measurement.

bfPWV appears to be feasible tool for noninvasive CVD risk assessment in children ages 2-4 years.