Kelishadi Roya, Sabri Mohammadreza, Motamedi Neda, Ramezani Mohammad Arash
Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
Pediatr Cardiol. 2009 May;30(4):477-81. doi: 10.1007/s00246-009-9412-7. Epub 2009 Mar 26.
The objective of this study was to determine the predictive factor of a combination of traditional and new risk factors for coronary heart diseases (CHDs) as well as the echocardiographic findings in children of parents suffering premature myocardial infarction in comparison with controls. Overall, 239 adolescents aged 12 to 18 years including 112 children of parents with premature CHD (<55 years) and 127 age- and sex-matched controls without such a family history. In addition to measuring anthropometric indexes and blood pressure, serum fasting blood sugar, lipid profile, C-reactive protein, Lpa, and oxidized LDL as well as carotid-intima media thickness and left ventricular mass were determined. Factor analysis showed that clusters of inflammatory factors and markers of oxidation as well as carotid-intima media thickness and left ventricular mass were correlated with each other and were associated with a positive parental history of premature CHD in youths. These findings complement the functional and structural changes in arteries of adults with a familial predisposition to CHD and underscore the importance of using a high-risk approach for primordial/primary prevention of CHD from early life and of considering the screening of children and siblings in the management of patients with premature CHD.
本研究的目的是确定冠心病(CHD)传统和新风险因素组合的预测因素,以及与对照组相比,父母患有早发性心肌梗死的儿童的超声心动图检查结果。总体而言,共有239名12至18岁的青少年,其中包括112名父母患有早发性冠心病(<55岁)的儿童和127名年龄和性别匹配、无此类家族史的对照组。除了测量人体测量指标和血压外,还测定了血清空腹血糖、血脂谱、C反应蛋白、Lpa、氧化型低密度脂蛋白以及颈动脉内膜中层厚度和左心室质量。因子分析表明,炎症因子和氧化标志物簇以及颈动脉内膜中层厚度和左心室质量相互关联,且与青少年父母早发性冠心病的阳性家族史相关。这些发现补充了具有冠心病家族易感性的成年人动脉的功能和结构变化,并强调了从生命早期就采用高危方法进行冠心病一级/初级预防以及在早发性冠心病患者管理中考虑对儿童和兄弟姐妹进行筛查的重要性。