© 2000 American Heart Association, Inc.
Vascular Biology |
Arterial Mechanical Changes in Children With Familial Hypercholesterolemia
From Service de Cardiologie Pédiatrique (Y.A., D.B., D.S.), Hôpital Necker Enfants Malades; Service de Physiologie Explorations Fonctionnelles AP-HP and Unit 541 INSERM (B.I.L.), Hôpital Lariboisière; Service de Médecine I (M.E.S.), Hôpital Broussais; Service de Gastroentérologie et Nutrition Pédiatrique (J.P.G.), Hôpital d’Enfants A. Trousseau; Service d’Endocrinologie Pédiatrique (M.P.), Hopital Robert Debré; and Service d’Endocrinologie-Métabolisme (E.B.), Groupe Hospitalier Pitié-Salpétrière, Paris, France.
Correspondence to Pr Bernard Levy, INSERM U541, 41 Bd de la Chapelle 75475, Paris Cedex 10, France. E-mail levy{at}infobiogen.fr
Abstract—Atherosclerosis is preceded by a phase of changes in the arterial wall that could have functional consequences even before the appearance of atheromatous changes. We hypothesized that early alterations of the mechanical properties of the arterial wall could precede clinical and echographic modifications. We used an automatic, computerized, ultrasonic procedure to evaluate geometric and mechanical characteristics of the common carotid artery (CCA) in normotensive children with primary familial class IIA hypercholesterolemia (FH; n=30; mean±SD age, 11±2 years old; mean±SD systolic/diastolic blood pressure, 109±9/55±7 mm Hg). These subjects were compared with age-matched, nonobese control subjects (n=27; 11±3 years old; 112±10/55±7 mm Hg). Noninvasive ultrasonic measurements were performed by the same investigator to measure the CCA luminal systolic and diastolic diameters and intima-media thickness (IMT). The cross-sectional compliance, cross-sectional distensibility, and the incremental elastic modulus of the CCA wall were then calculated. Finally, we assessed the degree of reactive hyperemia in the brachial artery produced after distal cuff occlusion and release. The changes in brachial arterial diameter in response to reactive hyperemia (endothelium-dependent dilation) and to glyceryltrinitrate (endothelium-independent dilation) were then measured. In patients with FH, we observed a significant reduction of systodiastolic variations in diameter (by 20%, P<0.001) without a significant difference in IMT. Cross-sectional compliance and cross-sectional distensibility were significantly reduced in FH subjects (by 15%, P<0.05 and 19%, P<0.01, respectively). In parallel, the incremental elastic modulus was significantly increased (by 27%, P<0.01) in children with FH. No correlation was evident between the carotid incremental modulus and either IMT or plasma low density lipoprotein cholesterol level. There was no difference in diameter of the brachial artery at rest in control and FH subjects (3.0±0.5 versus 3.0±0.4 mm). The reactive hyperemia and glyceryltrinitrate dilation were also similar in the 2 groups. However, the flow-mediated dilation of the brachial artery was smaller in the FH subjects (4.2±2.9%) than in controls (9.0±3.1%, P<0.001). In FH, endothelium-dependent dilation was negatively correlated with the plasma low density lipoprotein cholesterol level (P<0.04). These results indicate that increased stiffness of the CCA wall in children with FH is independent of blood pressure and could be related to endothelial dysfunction. Thus, alterations in CCA wall mechanics could be early and easily measurable markers of atheromatous changes in the arterial wall.
Key Words: endothelium • flow-dependent dilation • arterial compliance
This article has been cited by other articles:
 |
|
 |
|
  P. A. Stapleton, Adam. G. Goodwill, M. E. James, and J. C. Frisbee Altered mechanisms of endothelium-dependent dilation in skeletal muscle arterioles with genetic hypercholesterolemia Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2007; 293(3): R1110 - R1119. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Mariotti, J. F. Huneau, I. Szezepanski, K. J. Petzke, Y. Aggoun, D. Tome, and D. Bonnet Meal Amino Acids with Varied Levels of Arginine do Not Affect Postprandial Vascular Endothelial Function in Healthy Young Men J. Nutr., June 1, 2007; 137(6): 1383 - 1389. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. W. McCrindle, E. M. Urbina, B. A. Dennison, M. S. Jacobson, J. Steinberger, A. P. Rocchini, L. L. Hayman, and S. R. Daniels Drug Therapy of High-Risk Lipid Abnormalities in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, With the Council on Cardiovascular Nursing Circulation, April 10, 2007; 115(14): 1948 - 1967. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.-E. W. Kavey, V. Allada, S. R. Daniels, L. L. Hayman, B. W. McCrindle, J. W. Newburger, R. S. Parekh, and J. Steinberger Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics Circulation, December 12, 2006; 114(24): 2710 - 2738. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Laurent, J. Cockcroft, L. Van Bortel, P. Boutouyrie, C. Giannattasio, D. Hayoz, B. Pannier, C. Vlachopoulos, I. Wilkinson, H. Struijker-Boudier, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications Eur. Heart J., November 1, 2006; 27(21): 2588 - 2605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Pena, E. Wiltshire, K. MacKenzie, R. Gent, L. Piotto, C. Hirte, and J. Couper Vascular Endothelial and Smooth Muscle Function Relates to Body Mass Index and Glucose in Obese and Nonobese Children J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4467 - 4471. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Groner, M. Joshi, and J. A. Bauer Pediatric Precursors of Adult Cardiovascular Disease: Noninvasive Assessment of Early Vascular Changes in Children and Adolescents Pediatrics, October 1, 2006; 118(4): 1683 - 1691. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Covic, N. Mardare, P. Gusbeth-Tatomir, O. Brumaru, C. Gavrilovici, M. Munteanu, O. Prisada, and D. J. A. Goldsmith Increased arterial stiffness in children on haemodialysis Nephrol. Dial. Transplant., March 1, 2006; 21(3): 729 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Juonala, M. J. Jarvisalo, N. Maki-Torkko, M. Kahonen, J. S.A. Viikari, and O. T. Raitakari Risk Factors Identified in Childhood and Decreased Carotid Artery Elasticity in Adulthood: The Cardiovascular Risk in Young Finns Study Circulation, September 6, 2005; 112(10): 1486 - 1493. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Ladeia, C. Ladeia-Frota, L. Pinho, E. Stefanelli, and L. Adan Endothelial Dysfunction Is Correlated With Microalbuminuria in Children With Short-Duration Type 1 Diabetes Diabetes Care, August 1, 2005; 28(8): 2048 - 2050. [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Boreham, I. Ferreira, J. W. Twisk, A. M. Gallagher, M. J. Savage, and L. J. Murray Cardiorespiratory Fitness, Physical Activity, and Arterial Stiffness: The Northern Ireland Young Hearts Project Hypertension, November 1, 2004; 44(5): 721 - 726. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Iannuzzi, M. R. Licenziati, C. Acampora, V. Salvatore, L. Auriemma, M. L. Romano, S. Panico, P. Rubba, and M. Trevisan Increased Carotid Intima-Media Thickness and Stiffness in Obese Children Diabetes Care, October 1, 2004; 27(10): 2506 - 2508. [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Hutter, M. A. Austin, and S. E. Humphries Familial Hypercholesterolemia, Peripheral Arterial Disease, and Stroke: A HuGE Minireview Am. J. Epidemiol., September 1, 2004; 160(5): 430 - 435. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Slyper What Vascular Ultrasound Testing Has Revealed about Pediatric Atherogenesis, and a Potential Clinical Role for Ultrasound in Pediatric Risk Assessment J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3089 - 3095. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Oliver and D. J. Webb Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events Arterioscler. Thromb. Vasc. Biol., April 1, 2003; 23(4): 554 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Frick, S. P. Schwarzacher, H. F. Alber, A. Rinner, H. Ulmer, O. Pachinger, and F. Weidinger Morphologic rather than functional or mechanical sonographic parameters of the brachial artery are related to angiographically evident coronary atherosclerosis J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1825 - 1830. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. Kiefer, J. B. McKenney, J. F. Trainor, and L. M. Snyder Maturation-Dependent Acquired Coronary Structural Alterations and Atherogenesis in the Dahl Sodium-Sensitive Hypertensive Rat Circulation, November 5, 2002; 106(19): 2486 - 2490. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Sorof and S. Daniels Obesity Hypertension in Children: A Problem of Epidemic Proportions Hypertension, October 1, 2002; 40(4): 441 - 447. [Abstract] [Full Text] [PDF]
|
|