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Atherosclerosis in the pediatric age with special reference to initiation, progression and regression of
Insights
Atherosclerosis begins in childhood with intimal thickening and fatty streaks, increasing with age. Early prevention is crucial as these early lesions are integral to the development of atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Pediatric Pathology
- Atherosclerosis Research
Background:
- Fibromuscular intimal thickening and lipid deposition are observed early in pediatric patients.
- Fatty streaks frequently co-occur with intimal thickening, even in infants.
- These early atherosclerotic changes show significant individual variability.
Purpose of the Study:
- To investigate the early onset and progression of atherosclerotic lesions in pediatric populations.
- To establish the relationship between intimal thickening, lipid deposition, and fatty streaks.
- To emphasize the significance of early atherosclerotic changes as precursors to the disease.
Main Methods:
- Observational study analyzing the prevalence and characteristics of intimal thickening and fatty streaks.
- Age-based assessment of lesion development and progression.
- Correlation analysis between intimal thickening, lipid deposition, and age.
Main Results:
- Intimal thickening and lipid deposition increase with age, with high prevalence in infants and children.
- Fatty streaks are closely associated with intimal thickening.
- Lesion degree and extent exhibit considerable individual variability.
Conclusions:
- Intimal thickening is a fundamental component and the initial stage of atherosclerosis.
- Atherosclerotic lesions can develop from thrombosis and endothelial injury, accelerated by hyperlipidemia.
- Primary and secondary prevention strategies are essential due to lesion persistence and potential regression with scarring.
Abstract:
Fibromuscular intimal thickening begins to occur early in the pediatric age, with or without lipid deposition. Fatty streaks also appear first in infant. Fatty streaks occur almost always in close association with intimal thickening. Some fatty streaks remain unchanged as those seen in the ascending aorta. Intimal thickening and lipid deposition generally increase with age. The prevalence of those lesions is very high in infants and children. The degree and extent of those lesions display wide individual variability. Finally, intimal thickening is considered to be an integral part of atherosclerosis and to represent the first stage of atherosclerosis. Atherosclerotic lesions, at least a part of them, are derived from thrombosis in association with endothelial denudation. Hyperlipidemia accelerates the atherosclerotic process. Lipid-rich atherosclerotic lesions may regress to some degree under a long normolipidemic state but leave intimal fibrous scarring. Therefore primary prevention of atherosclerosis should be directed as well as secondary prevention.