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Vascular function and arterial stiffness in multisystem inflammatory syndrome in children with Covid-19
Alireza Ahmadi1, Mohammad Reza Sabri1, Mehdi Ghaderian1
1Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Children with MIS-C show signs of arterial stiffness and endothelial dysfunction, indicated by higher pulse pressure and lower flow-mediated dilation (FMD). Early cardiovascular monitoring is crucial for these patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Vascular Biology
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe post-COVID-19 complication.
- MIS-C can lead to significant cardiovascular issues, including endothelial dysfunction and arterial stiffness.
Purpose of the Study:
- To investigate cardiovascular health in children diagnosed with MIS-C.
- To compare vascular parameters between MIS-C patients and healthy controls.
Main Methods:
- A cohort study involving 59 children with MIS-C and 59 healthy controls.
- Non-invasive assessment of brachial artery flow-mediated dilation (FMD), aortic distensibility (AD), and aortic strain (AS).
Main Results:
- MIS-C patients exhibited higher systolic blood pressure and borderline elevated pulse pressure.
- Lower FMD, AS, and AD values were observed in the MIS-C group, though not statistically significant.
- Systolic blood pressure was significantly higher in the MIS-C group (P = 0.012).
Conclusions:
- Children with MIS-C display indicators of arterial stiffness and endothelial dysfunction.
- Flow-mediated dilation (FMD) may be a more sensitive marker for endothelial dysfunction in MIS-C.
- Emphasizes the need for vigilant cardiovascular assessment and monitoring in MIS-C patients due to long-term risks.
Background:
Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but severe condition that can develop in children who have had COVID-19. It can lead to cardiovascular complications, potentially caused by endothelial dysfunction and arterial stiffness.
Methods:
This study aimed to investigate the cardiovascular health of children with MIS-C compared to healthy controls. Fifty-nine children with MIS-C and fifty-nine healthy individuals were included in this cohort study. Non-invasive techniques were employed to measure the brachial artery's flow-mediated dilation (FMD), aortic distensibility (AD), and aortic strain (AS).
Results:
The MIS-C group demonstrated significantly higher systolic blood pressure (P = 0.012), with a mean of 100.2 (10.1) mmHg compared to 95.3 (9.6) mmHg in the healthy group. The relative risk (RR) for elevated pulse pressure in the MIS-C group was borderline higher than in the healthy group (RR 95% CI: 1.06 [1.01-1.14]; P = 0.046). However, FMD, AS, and AD values were lower in the MIS-C group, with means of 13.6 (8.9), 10.4 (4.1), and 15.5 (2.7), respectively, although no significant differences were observed (P > 0.05).
Conclusion:
Children with MIS-C exhibited higher pulse pressure, indicating potential arterial stiffness. They also showed lower FMD, suggesting endothelial dysfunction. FMD appears to be a more reliable indicator of endothelial dysfunction in MIS-C patients compared to aortic strain. These findings underscore the importance of early assessment and monitoring of cardiovascular complications in MIS-C patients. Endothelial dysfunction and arterial stiffness are well-established risk factors for future cardiovascular events.
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