AORTIC AND CAROTID INTIMA MEDIA THICKNESS AND FLOW MEDIATED DILATION AS MARKERS OF EARLY ATHEROSCLEROSIS IN A COHORT OF PEDIATRIC PATIENTS WITH RHEUMATIC DISEASES Del Giudice Emanuela1, Dilillo Anna1, Tromba Luciana2 , La Torre Giuseppe3 , Blasi Sara2, Conti Fabrizio4, Viola Franca1, Cucchiara Salvatore1, Duse Marzia 1 1 Department of Paediatrics and Infant Neuropsychiatry, Sapienza University of Rome, Rome, Italy 2 Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy 3 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy 4 Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy Keywords atherosclerosis, aortic intimal-medial thickness, carotid intimal-medial thickness, flow-mediated dilation, pediatric rheumatic diseases Key messages • Chronic inflammation appears to play a role in the development of atherosclerosis in rheumatic diseases • Subclinical atherosclerosis occurs in pediatric rheumatic diseases and aIMT might be an earlier marker Abstract Objectives The aims of this study were to identify the presence of endothelial dysfunction as marker of early atherosclerosis by measuring aortic and carotid intimal-medial thickness (aIMT and cIMT) and flow-mediated dilation (FMD) and their correlation with traditional and no traditional risk factors for atherosclerosis in children with rheumatic diseases. Methods 39 patients (mean age 15.3 +/- 5.7 years):23 Juvenile Idiopathic Arthritis, 9 Juvenile Spondyloarthropathies, 7 connective tissue diseases (mean disease duration and onset respectively 5 ± 3.6 years and 10 ± 5 years) and 52 healthy children matched for sex and age were enrolled. Demographic data (age, sex, familiarity for cardiovascular disease), traditional risk factors for atherosclerosis (BMI, active and passive smoking, dyslipidemia), activity disease indexes (reactive count protein, erythrocyte sedimentation rate) autoantibodies and complement tests were collected. aIMT, cIMT and FMD were assessed following a standardized protocol by high-resolution ultrasonography. Results Patients resulted significantly more exposed to passive smoking, and had lower BMI and higher homocysteine level than controls. cIMT and aIMT were significantly higher in patients than controls ( p <0.001) and correlated with age at diagnosis (p <0.001 r 0.516 and 0.706 respectively) but not with mean disease duration. FMD % was significantly reduced in patients vs controls (p<0.001). Conclusion. Subclinical atherosclerosis occurs in pediatric rheumatic diseases, mainly in early onset forms and aIMT is an earlier marker of preclinical atherosclerosis. Premature endothelial dysfunction could be included in the follow up of rheumatic children to plan prevention strategies of cardiovascular disease already in paediatrics.
Aortic and carotid Intima media thickness as marker of early atherosclerosis in pediatric rheumatic disease / DEL GIUDICE, Emanuela; Dilillo, ANNA RACHELE SERENA; Votto, M.; Tromba, Luciana; Viola, Franca; Conti, F.; Cucchiara, Salvatore; Duse, Marzia. - ELETTRONICO. - (2014). (Intervento presentato al convegno XIII Congress of Pediatric Italian Society of Rheumatology tenutosi a Turin nel 22-24 October 2014).
Aortic and carotid Intima media thickness as marker of early atherosclerosis in pediatric rheumatic disease
DEL GIUDICE, EMANUELA;DILILLO, ANNA RACHELE SERENA;TROMBA, Luciana;VIOLA, Franca;CUCCHIARA, Salvatore;DUSE, MARZIA
2014
Abstract
AORTIC AND CAROTID INTIMA MEDIA THICKNESS AND FLOW MEDIATED DILATION AS MARKERS OF EARLY ATHEROSCLEROSIS IN A COHORT OF PEDIATRIC PATIENTS WITH RHEUMATIC DISEASES Del Giudice Emanuela1, Dilillo Anna1, Tromba Luciana2 , La Torre Giuseppe3 , Blasi Sara2, Conti Fabrizio4, Viola Franca1, Cucchiara Salvatore1, Duse Marzia 1 1 Department of Paediatrics and Infant Neuropsychiatry, Sapienza University of Rome, Rome, Italy 2 Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy 3 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy 4 Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy Keywords atherosclerosis, aortic intimal-medial thickness, carotid intimal-medial thickness, flow-mediated dilation, pediatric rheumatic diseases Key messages • Chronic inflammation appears to play a role in the development of atherosclerosis in rheumatic diseases • Subclinical atherosclerosis occurs in pediatric rheumatic diseases and aIMT might be an earlier marker Abstract Objectives The aims of this study were to identify the presence of endothelial dysfunction as marker of early atherosclerosis by measuring aortic and carotid intimal-medial thickness (aIMT and cIMT) and flow-mediated dilation (FMD) and their correlation with traditional and no traditional risk factors for atherosclerosis in children with rheumatic diseases. Methods 39 patients (mean age 15.3 +/- 5.7 years):23 Juvenile Idiopathic Arthritis, 9 Juvenile Spondyloarthropathies, 7 connective tissue diseases (mean disease duration and onset respectively 5 ± 3.6 years and 10 ± 5 years) and 52 healthy children matched for sex and age were enrolled. Demographic data (age, sex, familiarity for cardiovascular disease), traditional risk factors for atherosclerosis (BMI, active and passive smoking, dyslipidemia), activity disease indexes (reactive count protein, erythrocyte sedimentation rate) autoantibodies and complement tests were collected. aIMT, cIMT and FMD were assessed following a standardized protocol by high-resolution ultrasonography. Results Patients resulted significantly more exposed to passive smoking, and had lower BMI and higher homocysteine level than controls. cIMT and aIMT were significantly higher in patients than controls ( p <0.001) and correlated with age at diagnosis (p <0.001 r 0.516 and 0.706 respectively) but not with mean disease duration. FMD % was significantly reduced in patients vs controls (p<0.001). Conclusion. Subclinical atherosclerosis occurs in pediatric rheumatic diseases, mainly in early onset forms and aIMT is an earlier marker of preclinical atherosclerosis. Premature endothelial dysfunction could be included in the follow up of rheumatic children to plan prevention strategies of cardiovascular disease already in paediatrics.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.