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Ultrasound Assessment of Aortic and Carotid Artery Intima-media Thickness in Children and Adolescents
Reeja Nasir1, Michael Skilton2, Adrienne Gordon3
1The Boden Initiative, Charles Perkins Centre, University of Sydney; reeja.nasir@sydney.edu.au.
Insights
Measuring intima-media thickness (IMT) in children helps detect early atherosclerosis. This study details methods for assessing IMT in the abdominal aorta and carotid artery for better cardiovascular disease risk assessment.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Medical Imaging
Background:
- Subclinical atherosclerosis, a precursor to cardiovascular disease, begins early in life.
- Intima-media thickness (IMT) measurement is a key biomarker for assessing subclinical atherosclerosis.
- Early detection of arterial changes in youth is crucial for long-term cardiovascular health.
Purpose of the Study:
- To provide a detailed methodology for high-quality intima-media thickness (IMT) assessment in the pediatric population.
- To compare the suitability of the abdominal aorta and common carotid artery for IMT measurement in young individuals.
- To guide researchers in selecting appropriate vascular sites for studying early-life exposures and later-life cardiovascular disease.
Main Methods:
- High-resolution B-mode ultrasonography was employed for IMT measurements.
- Stepwise protocols were developed for assessing IMT in the abdominal aorta and common carotid artery.
- Technical challenges specific to pediatric IMT measurement were addressed.
Main Results:
- Atherosclerotic lesions manifest at different ages across the vascular tree, with the aorta affected earlier than the carotid artery.
- Specific technical considerations are necessary for accurate IMT assessment in younger children.
- The study provides a robust method for pediatric IMT measurement.
Conclusions:
- Accurate measurement of intima-media thickness (IMT) in childhood and adolescence is feasible and valuable for assessing cardiovascular risk.
- The choice of vascular site (abdominal aorta vs. common carotid artery) depends on the age group and research objectives.
- Standardized methodologies are essential for reliable assessment of early atherosclerosis in youth.
Abstract:
Carotid intima-media thickness (IMT), measured using high-resolution B-mode ultrasonography, is a widely utilized surrogate marker of subclinical atherosclerosis, the pathophysiological process underlying most clinical cardiovascular disease events. Atherosclerosis is a gradual disease that originates early in life, thus, there has been increased interest in measuring carotid IMT in childhood and adolescence to assess structural change in the arterial vasculature in response to adverse exposures. However, the timing of atherosclerosis varies across the vascular tree. Primordial atherosclerotic lesions are present in the abdominal aorta as early as infancy, compared to mid-adolescence for the common carotid. Measurement of IMT at either site is susceptible to several technical challenges that need to be considered, especially in younger children. In this paper, we provide a detailed stepwise method for high-quality assessment of IMT of the abdominal aorta and common carotid artery in the young. We also provide insight into the appropriateness of either site when exploring the associations between early-life exposures and later-life cardiovascular disease.
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