Key result
Chronic disease in adolescents is linked to increased aortic stiffness and wall thickness vs controls.
Why the study?
Adolescents with chronic disease face risk factors for early atherosclerosis, and postmortem studies show atherogenesis starts in the aorta, motivating investigation into preclinical aortic atherosclerosis in this group.
Do adolescents with chronic disease have increased preclinical aortic atherosclerosis compared to healthy controls?
Cross-Sectional (n=114)
No
Do adolescents with chronic disease have increased preclinical aortic atherosclerosis compared to healthy controls?
Adolescents with chronic diseases such as cystic fibrosis, coarctation of the aorta, juvenile idiopathic arthritis, and obesity exhibit enhanced aortic stiffness and wall thickness, indicating accelerated atherogenesis and highlighting the need for tailored cardiovascular follow-up.
Answers are grounded in this paper and cite their sources.
May support early vascular monitoring in adolescents with chronic diseases; hypothesis-generating, longitudinal studies needed before practice change.
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.
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Ververs et al. (2022) conducted a cross-sectional in Chronic disease (cystic fibrosis, coarctation of the aorta, juvenile idiopathic arthritis, obesity) (n=114). Chronic disease vs. Healthy controls with a corrected atrial septal defect was evaluated on Aortic pulse wave velocity and aortic wall thickness (p=<0.05). Adolescents with chronic diseases had significantly higher aortic pulse wave velocity and aortic wall thickness compared to controls (P<0.05), indicating enhanced aortic stiffness and early atherogenesis.
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