Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease
Background Adolescents with chronic disease are often exposed to inflammatory, metabolic, and hemodynamic risk factors for early atherosclerosis. Since postmortem studies have shown that atherogenesis starts in the aorta, the CDACD (Cardiovascular Disease in Adolescents with Chronic Disease) study i...
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.024675 |
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| author | Francesca A. Ververs Anouk L. M. Eikendal Daniel Kofink Roos Nuboer Jos J. M. Westenberg Gijs T. Hovenkamp Jitske J.A. Kemps Iris C. J. Coenen Joëlle J. N. Daems Laura R. Claus Yillie Ju Nico M. Wulffraat Cornelis K. van der Ent Claudia Monaco Marianne Boes Tim Leiner Heynric B. Grotenhuis Henk S. Schipper |
| author_facet | Francesca A. Ververs Anouk L. M. Eikendal Daniel Kofink Roos Nuboer Jos J. M. Westenberg Gijs T. Hovenkamp Jitske J.A. Kemps Iris C. J. Coenen Joëlle J. N. Daems Laura R. Claus Yillie Ju Nico M. Wulffraat Cornelis K. van der Ent Claudia Monaco Marianne Boes Tim Leiner Heynric B. Grotenhuis Henk S. Schipper |
| author_sort | Francesca A. Ververs |
| collection | DOAJ |
| description | Background Adolescents with chronic disease are often exposed to inflammatory, metabolic, and hemodynamic risk factors for early atherosclerosis. Since postmortem studies have shown that atherogenesis starts in the aorta, the CDACD (Cardiovascular Disease in Adolescents with Chronic Disease) study investigated preclinical aortic atherosclerosis in these adolescents. Methods and Results The cross‐sectional CDACD study enrolled 114 adolescents 12 to 18 years old with chronic disorders including juvenile idiopathic arthritis, cystic fibrosis, obesity, corrected coarctation of the aorta, and healthy controls with a corrected atrial septal defect. Cardiovascular magnetic resonance was used to assess aortic pulse wave velocity and aortic wall thickness, as established aortic measures of preclinical atherosclerosis. Cardiovascular magnetic resonance showed a higher aortic pulse wave velocity, which reflects aortic stiffness, and higher aortic wall thickness in all adolescent chronic disease groups, compared with controls (P<0.05). Age (β=0.253), heart rate (β=0.236), systolic blood pressure (β=−0.264), and diastolic blood pressure (β=0.365) were identified as significant predictors for aortic pulse wave velocity, using multivariable linear regression analysis. Aortic wall thickness was predicted by body mass index (β=0.248) and fasting glucose (β=0.242), next to aortic lumen area (β=0.340). Carotid intima‐media thickness was assessed using ultrasonography, and was only higher in adolescents with coarctation of the aorta, compared with controls (P<0.001). Conclusions Adolescents with chronic disease showed enhanced aortic stiffness and wall thickness compared with controls. The enhanced aortic pulse wave velocity and aortic wall thickness in adolescents with chronic disease could indicate accelerated atherogenesis. Our findings underscore the importance of the aorta for assessment of early atherosclerosis, and the need for tailored cardiovascular follow‐up of children with chronic disease. |
| first_indexed | 2024-04-10T18:24:37Z |
| format | Article |
| id | doaj.art-7c1b33edddcb491287e3d41c988243a7 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T18:24:37Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7c1b33edddcb491287e3d41c988243a72023-02-02T06:20:21ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-07-01111410.1161/JAHA.122.024675Preclinical Aortic Atherosclerosis in Adolescents With Chronic DiseaseFrancesca A. Ververs0Anouk L. M. Eikendal1Daniel Kofink2Roos Nuboer3Jos J. M. Westenberg4Gijs T. Hovenkamp5Jitske J.A. Kemps6Iris C. J. Coenen7Joëlle J. N. Daems8Laura R. Claus9Yillie Ju10Nico M. Wulffraat11Cornelis K. van der Ent12Claudia Monaco13Marianne Boes14Tim Leiner15Heynric B. Grotenhuis16Henk S. Schipper17Center for Translational Immunology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Radiology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Cardiology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatrics Meander Medical Center Amersfoort Amersfoort the NetherlandsDepartment of Radiology Leiden University Medical Center Leiden the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Immunology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Pulmonology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsKennedy Institute of RheumatologyUniversity of Oxford Oxford UKCenter for Translational Immunology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Radiology University Medical Center Utrecht Utrecht the NetherlandsDepartment of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the NetherlandsCenter for Translational Immunology University Medical Center Utrecht Utrecht the NetherlandsBackground Adolescents with chronic disease are often exposed to inflammatory, metabolic, and hemodynamic risk factors for early atherosclerosis. Since postmortem studies have shown that atherogenesis starts in the aorta, the CDACD (Cardiovascular Disease in Adolescents with Chronic Disease) study investigated preclinical aortic atherosclerosis in these adolescents. Methods and Results The cross‐sectional CDACD study enrolled 114 adolescents 12 to 18 years old with chronic disorders including juvenile idiopathic arthritis, cystic fibrosis, obesity, corrected coarctation of the aorta, and healthy controls with a corrected atrial septal defect. Cardiovascular magnetic resonance was used to assess aortic pulse wave velocity and aortic wall thickness, as established aortic measures of preclinical atherosclerosis. Cardiovascular magnetic resonance showed a higher aortic pulse wave velocity, which reflects aortic stiffness, and higher aortic wall thickness in all adolescent chronic disease groups, compared with controls (P<0.05). Age (β=0.253), heart rate (β=0.236), systolic blood pressure (β=−0.264), and diastolic blood pressure (β=0.365) were identified as significant predictors for aortic pulse wave velocity, using multivariable linear regression analysis. Aortic wall thickness was predicted by body mass index (β=0.248) and fasting glucose (β=0.242), next to aortic lumen area (β=0.340). Carotid intima‐media thickness was assessed using ultrasonography, and was only higher in adolescents with coarctation of the aorta, compared with controls (P<0.001). Conclusions Adolescents with chronic disease showed enhanced aortic stiffness and wall thickness compared with controls. The enhanced aortic pulse wave velocity and aortic wall thickness in adolescents with chronic disease could indicate accelerated atherogenesis. Our findings underscore the importance of the aorta for assessment of early atherosclerosis, and the need for tailored cardiovascular follow‐up of children with chronic disease.https://www.ahajournals.org/doi/10.1161/JAHA.122.024675adolescentsatherosclerosischildrenchronic diseasecIMTCMR |
| spellingShingle | Francesca A. Ververs Anouk L. M. Eikendal Daniel Kofink Roos Nuboer Jos J. M. Westenberg Gijs T. Hovenkamp Jitske J.A. Kemps Iris C. J. Coenen Joëlle J. N. Daems Laura R. Claus Yillie Ju Nico M. Wulffraat Cornelis K. van der Ent Claudia Monaco Marianne Boes Tim Leiner Heynric B. Grotenhuis Henk S. Schipper Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease adolescents atherosclerosis children chronic disease cIMT CMR |
| title | Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease |
| title_full | Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease |
| title_fullStr | Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease |
| title_full_unstemmed | Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease |
| title_short | Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease |
| title_sort | preclinical aortic atherosclerosis in adolescents with chronic disease |
| topic | adolescents atherosclerosis children chronic disease cIMT CMR |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.024675 |
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