Thurn Daniela, Doyon Anke, Sözeri Betul, Bayazit Aysun K, Canpolat Nur, Duzova Ali, Querfeld Uwe, Schmidt Bernhard M W, Schaefer Franz, Wühl Elke, Melk Anette
Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany;
Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany;
Am J Hypertens. 2015 Dec;28(12):1480-8. doi: 10.1093/ajh/hpv048. Epub 2015 May 5.
Aortic pulse wave velocity (PWV), an indicator of arterial stiffness, independently predicts cardiovascular mortality risk in adults. Arterial stiffening advances with age and seems accelerated in children with certain disease conditions such as chronic kidney disease or diabetes. The Vicorder, an oscillometric device to measure PWV, has been validated in children, but reference values in a large pediatric cohort, association to carotid stiffness and influence of individual and family risk factors have not been determined.
Pulse waves were captured in 1,003 healthy children (aged 6-18 years) in 6 centers and gender-specific reference data normalized to age/height were constructed. In 589 children carotid distensibility and intima media thickness were measured. Gestational and family history was reported.
PWV correlated with age (r = 0.57, P < 0.0001) with significant gender-related differences starting at age 9. Further significant correlations were seen for height, weight, body mass index, blood pressure, pulse pressure, and heart rate. Independent predictors for PWV in a multivariate regression analysis were gender, age, height, weight, mean arterial pressure, and heart rate. Risk factors for higher PWV included small for gestational age at birth, secondhand smoking, parental hypertension, and obesity. PWV showed weak correlations with 2 of the carotid distensibility measures, but not with intima media thickness.
This study defines reference values for PWV captured by the Vicorder device in children and adolescents and reveals associations with potential cardiovascular risk factors in a healthy population. Gender-specific percentiles for age/height will allow for the assessment of pediatric cohorts using this oscillometric method.
主动脉脉搏波速度（PWV）是动脉僵硬度的一个指标，可独立预测成年人的心血管死亡风险。动脉僵硬度随年龄增长而增加，在患有某些疾病（如慢性肾病或糖尿病）的儿童中似乎加速。Vicorder是一种用于测量PWV的示波装置，已在儿童中得到验证，但尚未确定大型儿科队列中的参考值、与颈动脉僵硬度的关联以及个体和家庭风险因素的影响。
在6个中心对1003名健康儿童（6至18岁）采集脉搏波，并构建按年龄/身高标准化的特定性别参考数据。对589名儿童测量颈动脉扩张性和内膜中层厚度。报告妊娠和家族史。
PWV与年龄相关（r = 0.57，P < 0.0001），从9岁开始存在显著的性别差异。身高、体重、体重指数、血压、脉压和心率也存在进一步的显著相关性。多变量回归分析中PWV的独立预测因素为性别、年龄、身高、体重、平均动脉压和心率。较高PWV的风险因素包括出生时小于胎龄、二手烟暴露、父母高血压和肥胖。PWV与2项颈动脉扩张性测量指标呈弱相关，但与内膜中层厚度无关。
本研究确定了Vicorder装置在儿童和青少年中采集的PWV参考值，并揭示了与健康人群中潜在心血管风险因素的关联。按年龄/身高划分的特定性别百分位数将有助于使用这种示波法评估儿科队列。
