Li Ming Gan

Obese children show increased intimal wall thickness and decreased pulse wave velocity

Objective:u2002 Childhood obesity confers an increased risk of vascular changes and adult cardiovascular disease. Using a high‐resolution ultrasound technique that enables separation of intimal and medial layers, we examined the intimal thickness (IT) and intimal–medial thickness (IMT) of radial (RA) and dorsal pedal (DPA) arteries and the pulse wave velocity (PWV) in overweight/obese children and adolescents and in healthy subjects.

Anger, depression and anxiety associated with endothelial function in childhood and adolescence

Objective Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. The authors assessed associations of reactive hyperaemia peripheral arterial tonometry (RH-PAT), a measure of endothelial function predictive of CVD, with self-assessed psychological health among school children. Methods A total of 248 healthy school children (mean (SD) age 14.0 (1.0); 136 girls and 112 boys) underwent RH-PAT testing. They completed the Beck Youth Inventories (BYI) of emotional and social impairment scales, which is used to screen for depression, anxiety, anger and disruptive behaviour. Results No sex differences were observed for the RH-PAT score. Statistically significant differences were observed for the BYI scores; girls had higher scores for depression, anger and anxiety. Among the girls, there were statistically significant associations between lower RH-PAT scores and higher scores for anger (B coefficient=−0.100, p=0.040), depression (−0.108, p=0.009) and anxiety (−0.138, p=0.039) after adjustment for age. Among the boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006). Conclusions The girls have higher levels of self-assessed anger; depression and anxiety compared with the boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among the boys, disruptive behaviour was associated with better endothelial function. Although psychological ill-health is associated with impaired endothelial function and CVD among adults, such processes may also be relevant to children. Psychosocial adversity in childhood might be a risk factor for subsequent CVD.

Sex differences in peripheral artery intima, media and intima media thickness in children and adolescents.

OBJECTIVEnMales have higher coronary heart disease (CHD) lifetime risk and increased magnitude of atherosclerosis, compared with women. Using very high-resolution ultrasound, we have shown that the intima thickness (IT) of radial and dorsal pedal arteries, measured separately from the media thickness (MT), increases with age. We wanted to test whether there is already a difference between the sexes in childhood for IT, MT and intima media thickness (IMT) in the radial and dorsal pedal arteries.nnnMETHODS AND RESULTSnA total of 252 children (age 14.5 years S.D.+/-1.0girls/boys 139/113) from two schools in Gothenburg, Sweden, participated in the study. The high-resolution (55MHz) ultrasound measurements showed that boys had larger values than girls for the radial IT (0.057+/-0.010mm vs. 0.054+/-0.008mm, P=0.007), MT (0.176+/-0.033 vs. 0.153+/-0.025, P=0.031), IMT (0.232+/-0.035 vs. 0.207+/-0.026, P=0.000), and for dorsal pedal artery MT (0.160+/-0.039 vs. 0.149+/-0.034, P=0.022) and IMT (0.222+/-0.041 vs. 0.209+/-0.037, P=0.016).nnnCONCLUSIONnWith this new very high-resolution ultrasound technique, we demonstrated in a large study population of children, that both intimal and medial arterial wall layers were thicker in boys than in girls. These findings may constitute an early background explaining why CHD starts sooner in men compared with women.

Increased intima thickness of the radial artery in individuals with prehypertension and hypertension

BACKGROUNDnWe have used a novel ultra high-frequency (55MHz) ultrasound technique to non-invasively measure the radial arterial vessel wall and separate the intima-media (IMT) complex into measurements of intima and media thickness (IT and MT). Since no previous study has measured IT and MT separately in individuals with prehypertension and hypertension, the aim of the current study was to measure IT and MT thickness of the radial arteries among individuals with prehypertension, hypertension and healthy subjects.nnnMETHODS AND RESULTSnIndividuals with prehypertension (n=32), hypertension (n=34) and healthy subjects (n=29) underwent ultra high-resolution ultrasound of the radial artery. Individuals with prehypertension showed a 14% increase in IT compared to healthy subjects (0.083+/-0.020mm versus 0.073+/-0.015mm; p<0.05), whereas no difference was seen in MT. Individuals with hypertension showed a 12% increase of in IT compared to healthy subjects (0.082+/-0.018mm versus 0.073+/-0.015mm, p<0.05), whereas no differences were seen regarding MT. Prehypertensive and hypertensive individuals did not differ regarding IT and MT.nnnCONCLUSIONnBoth prehypertension and hypertension are associated with thickening of the intimal layer of the radial artery. The present data indicates that intima thickening appears early during the development of hypertension even when blood pressure is only slightly elevated.

High-resolution ultrasound showing increased intima and media thickness of the radial artery in patients with end-stage renal disease.

OBJECTIVEnAlthough clinically relevant atherosclerosis of the upper limb arteries is rarely seen, intimal hyperplasia of the arteries may reflect global atherosclerosis and increased intima-media thickness of the brachial artery has been linked to an increased risk of cardiovascular events and to early failure of the radiocephalic arteriovenous fistula. We speculated that patients with ESRD have thickening of both the radial intimal and medial layers compared to healthy subjects.nnnMETHODSnUltrasound biomicroscopy is a novel very high frequency (55 MHz) ultrasound technique that could accurately measure the intima and media thickness of the vessel wall. No previous study has measured intima and media thickness separately in patients with end-stage renal disease and hence, the aim of the current study was to investigate the radial arterial wall layers in patients with chronic renal failure.nnnRESULTSnThirty-one patients with end-stage renal disease and 41 healthy subjects underwent ultrasound biomicroscopy of the radial arteries. Blood pressures did not differ except for pulse pressures which were elevated among patients with end-stage renal disease (p<0.01). Patients with end-stage renal disease showed 39% thicker intima and 18% greater media in the radial artery compared to healthy subjects (0.117+/-0.031 mm versus 0.084+/-0.02 mm for the IT, p<0.01 and 0.205+/-0.062 mm versus 0.174+/-0.044 mm for the MT; p<0.05).nnnCONCLUSIONSnBoth the intima and the media layers of the radial arteries are increased in patients with end-stage renal disease. Whether measurements of the radial arterial intima thickness may convey valuable information on the risk of future cardiovascular events and early arteriovenous fistula failure in end-stage renal disease remain to be elucidated in future studies.

Increased intima thickness of the radial artery in patients with coronary heart disease

Ultrabiomicroscopy is a novel high-frequency (55 MHz) ultrasound technique that could be used to non-invasively measure the vessel wall and separate the intima—media complex into measurements of intima and media thickness. Since no previous study has measured intima and media thickness separately in vivo in patients with coronary heart disease (CHD), the aim of the current study was to measure intima and intima—media thickness of the radial and the anterior tibial arteries among patients with CHD and healthy subjects (HS). Thirty-two patients with CHD and 46 HS underwent investigations with ultrabiomicroscopy measurements of the radial and anterior tibial arteries. Patients with CHD showed a 19% increase in intima thickness of the radial artery compared with HS (0.088 ± 0.024 mm versus 0.074 ± 0.015 mm; p < 0.015), whereas no difference was seen in media thickness. There were no differences in intima or media thickness within the anterior tibial arteries. In conclusion, CHD is associated with thickening of the intima of the radial artery whereas media thickness was unchanged compared with HS. Assessment of intima thickness by high-frequency ultrasound may provide a tool for non-invasive early detection of atherosclerosis.