Ahmadi Alireza, Sabri Mohammad Reza, Ghaderian Mehdi, Dehghan Bahar, Mahdavi Chehreh, Ramezaninezhad Davood, Pourmoghaddas Zahra, Maracy Mohammad Reza, Nemat Gorgani Pejman, Ghazanfari Behzad
Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Epidemiology and Biostatistics, School of public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2025;21(1):54-62. doi: 10.48305/arya.2025.43214.3008.
Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but severe condition that can develop in children who have had COVID-19. It can lead to cardiovascular complications, potentially caused by endothelial dysfunction and arterial stiffness.
This study aimed to investigate the cardiovascular health of children with MIS-C compared to healthy controls. Fifty-nine children with MIS-C and fifty-nine healthy individuals were included in this cohort study. Non-invasive techniques were employed to measure the brachial artery's flow-mediated dilation (FMD), aortic distensibility (AD), and aortic strain (AS).
The MIS-C group demonstrated significantly higher systolic blood pressure (P = 0.012), with a mean of 100.2 (10.1) mmHg compared to 95.3 (9.6) mmHg in the healthy group. The relative risk (RR) for elevated pulse pressure in the MIS-C group was borderline higher than in the healthy group (RR 95% CI: 1.06 [1.01-1.14]; P = 0.046). However, FMD, AS, and AD values were lower in the MIS-C group, with means of 13.6 (8.9), 10.4 (4.1), and 15.5 (2.7), respectively, although no significant differences were observed (P > 0.05).
Children with MIS-C exhibited higher pulse pressure, indicating potential arterial stiffness. They also showed lower FMD, suggesting endothelial dysfunction. FMD appears to be a more reliable indicator of endothelial dysfunction in MIS-C patients compared to aortic strain. These findings underscore the importance of early assessment and monitoring of cardiovascular complications in MIS-C patients. Endothelial dysfunction and arterial stiffness are well-established risk factors for future cardiovascular events.
儿童多系统炎症综合征（MIS-C）是一种罕见但严重的疾病，可发生于曾感染新型冠状病毒肺炎（COVID-19）的儿童。它可导致心血管并发症，可能由内皮功能障碍和动脉僵硬度增加引起。
本研究旨在调查与健康对照相比，MIS-C患儿的心血管健康状况。本队列研究纳入了59例MIS-C患儿和59名健康个体。采用非侵入性技术测量肱动脉血流介导的舒张功能（FMD）、主动脉扩张性（AD）和主动脉应变（AS）。
MIS-C组的收缩压显著更高（P = 0.012），平均为100.2（10.1）mmHg，而健康组为95.3（9.6）mmHg。MIS-C组脉压升高的相对风险略高于健康组（RR 95% CI：1.06 [1.01 - 1.14]；P = 0.046）。然而，MIS-C组的FMD、AS和AD值较低，平均值分别为13.6（8.9）、10.4（4.1）和15.5（2.7），尽管未观察到显著差异（P > 0.05）。
MIS-C患儿表现出更高的脉压，表明存在潜在的动脉僵硬度增加。他们还表现出较低的FMD，提示内皮功能障碍。与主动脉应变相比，FMD似乎是MIS-C患者内皮功能障碍更可靠的指标。这些发现强调了早期评估和监测MIS-C患者心血管并发症的重要性。内皮功能障碍和动脉僵硬度增加是未来心血管事件公认的危险因素。
