Preclinical aortic atherosclerosis in adolescents with chronic disease
<p><strong>Background: </strong>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 Dise...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
American Heart Association
2022
|
| _version_ | 1797109422048149504 |
|---|---|
| author | Ververs, FA Eikendal, ALM Kofink, D Nuboer, R Westenberg, JJM Hovenkamp, GT Kemps, JJA Coenen, ICJ Daems, JJN Claus, LR Ju, Y Wulffraat, NM van der Ent, CK Monaco, C Boes, M Leiner, T Grotenhuis, HB Schipper, HS |
| author_facet | Ververs, FA Eikendal, ALM Kofink, D Nuboer, R Westenberg, JJM Hovenkamp, GT Kemps, JJA Coenen, ICJ Daems, JJN Claus, LR Ju, Y Wulffraat, NM van der Ent, CK Monaco, C Boes, M Leiner, T Grotenhuis, HB Schipper, HS |
| author_sort | Ververs, FA |
| collection | OXFORD |
| description | <p><strong>Background: </strong>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.</p>
<p><strong>Methods and Results: </strong>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 (<em>P</em><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 (<em>P</em><0.001).</p>
<p><strong>Conclusions: </strong>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.</p> |
| first_indexed | 2024-03-07T07:41:42Z |
| format | Journal article |
| id | oxford-uuid:ef74135a-7561-4388-b581-8343bc929e6f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:41:42Z |
| publishDate | 2022 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:ef74135a-7561-4388-b581-8343bc929e6f2023-04-27T06:19:51ZPreclinical aortic atherosclerosis in adolescents with chronic diseaseJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ef74135a-7561-4388-b581-8343bc929e6fEnglishSymplectic ElementsAmerican Heart Association 2022Ververs, FAEikendal, ALMKofink, DNuboer, RWestenberg, JJMHovenkamp, GTKemps, JJACoenen, ICJDaems, JJNClaus, LRJu, YWulffraat, NMvan der Ent, CKMonaco, CBoes, MLeiner, TGrotenhuis, HBSchipper, HS<p><strong>Background: </strong>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.</p> <p><strong>Methods and Results: </strong>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 (<em>P</em><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 (<em>P</em><0.001).</p> <p><strong>Conclusions: </strong>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.</p> |
| spellingShingle | Ververs, FA Eikendal, ALM Kofink, D Nuboer, R Westenberg, JJM Hovenkamp, GT Kemps, JJA Coenen, ICJ Daems, JJN Claus, LR Ju, Y Wulffraat, NM van der Ent, CK Monaco, C Boes, M Leiner, T Grotenhuis, HB Schipper, HS Preclinical aortic atherosclerosis in adolescents with chronic disease |
| 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 |
| work_keys_str_mv | AT verversfa preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT eikendalalm preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT kofinkd preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT nuboerr preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT westenbergjjm preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT hovenkampgt preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT kempsjja preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT coenenicj preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT daemsjjn preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT clauslr preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT juy preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT wulffraatnm preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT vanderentck preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT monacoc preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT boesm preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT leinert preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT grotenhuishb preclinicalaorticatherosclerosisinadolescentswithchronicdisease AT schipperhs preclinicalaorticatherosclerosisinadolescentswithchronicdisease |