Zhao Bing, Johnston Fay H, Dalton Marita, Negishi Kazuaki
Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia.
Sydney Medical School Nepean, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Pediatr Cardiol. 2019 Jun;40(5):914-920. doi: 10.1007/s00246-019-02088-1. Epub 2019 Mar 16.
In adults, noninvasive assessments of vascular function have been established. However, little is known about the applicability and reference values of these techniques among children < 6 years old and none ≤ 2. We aimed to determine the feasibility of conducting noninvasive vascular assessments in 2-year-old children and the normal range of results in this age group.
Carotid intima-media thickness (cIMT) and abdominal aorta IMT (aaIMT), pulse wave velocity (PWV), arterial diameter change, stiffness index (β), and distensibility were assessed in 2-year-old children. IMT was assessed using an automatic contour detection.
The proportion of successful measurements was 72% (42/58) with cIMT 64%, aaIMT 67%, and PWV 43%. Average far wall cIMT was 0.51 mm and 0.40 for aaIMT. Mean PWV was 4.15 m/s, with relatively wider range in stiffness index and distensibility. Common carotid arteries had a higher mean distensibility of 4.58%/10 mmHg compared with 2.98%/10 mmHg for the abdominal aorta. The number of data points automatically detected at far wall cIMT was higher than that in aaIMT (left cIMT: 244 ± 13 and right: 240 ± 23 vs. abdominal 185 ± 63, p < 0.001). Better and more consistent quality was achieved for cIMT than aaIMT measurements. PWV measurement was only feasible in cooperative children with efficient distractions.
Noninvasive methods for early detection of cardiovascular risks were feasible in at least two-thirds of 2-year-old children. Given the greater feasibility and image quality, cIMT is a preferable option for assessing vascular health in young children.
在成人中，已经建立了血管功能的非侵入性评估方法。然而，对于6岁以下儿童，尤其是2岁及以下儿童，这些技术的适用性和参考值知之甚少。我们旨在确定对2岁儿童进行非侵入性血管评估的可行性以及该年龄组的正常结果范围。
对2岁儿童进行颈动脉内膜中层厚度（cIMT）、腹主动脉内膜中层厚度（aaIMT）、脉搏波速度（PWV）、动脉直径变化、硬度指数（β）和扩张性评估。使用自动轮廓检测评估内膜中层厚度。
成功测量的比例为72%（42/58），其中cIMT为64%，aaIMT为67%，PWV为43%。远壁cIMT的平均值为0.51mm，aaIMT为0.40mm。平均PWV为4.15m/s，硬度指数和扩张性的范围相对较宽。颈总动脉的平均扩张性较高，为4.58%/10mmHg，而腹主动脉为2.98%/10mmHg。远壁cIMT自动检测到的数据点数量高于aaIMT（左cIMT：244±13，右：240±23，而腹主动脉为185±63，p<0.001）。cIMT测量的质量比aaIMT更好且更一致。PWV测量仅在能有效分散注意力的配合良好的儿童中可行。
至少三分之二的2岁儿童可行早期检测心血管风险的非侵入性方法。鉴于更高的可行性和图像质量，cIMT是评估幼儿血管健康的更优选择。
