Carotid artery non invasive elastography (NIVE) to detect early changes of cardiovascular diseases in overweight and obese children

Abstract

Increased arterial stiffness is one of the first signs of atherosclerosis. The objective of this study was to use non-invasive elastography (NIVE) to detect early changes in vascular biomechanics associated with obesity in children. The NIVE algorithm also measured the intimamedia thickness (IMT) for comparison.NIVE was applied in 120 children, 60 with elevated body mass index (BMI) (≥ 85th percentile for age and sex) and 60 non-overweight (BMI < 85th percentile). Participants were randomly selected from a longitudinal cohort, evaluating consequences of obesity in healthy children with one obese parent. The carotid wall was automatically segmented and elastograms were computed to measure the cumulated axial strain (CAS), cumulated axial translation (CAT), and maximal shear strain (Max |SSE|); IMT was also computed from segmented contours. Elastogram features were compared between groups with multivariate analyses to control for age, sex, Tanner stage, blood pressure, and lowdensity lipoprotein cholesterol (LDL).After Bonferroni correction, CAT was significantly higher in the elevated BMI group (0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm), p < 0.001. CAS/CAT was significantly lower in the elevated BMI group (9.54 ± 4.8 %/mm vs. 13.34 ± 6.46 %/mm), p = 0.001; the lower CAS/CAT ratio suggests stiffer arteries with less deformation for a similar translation.Before Bonferroni correction, IMT was significantly higher in the elevated BMI group (0.36 ± 0.05 mm vs. 0.32 ± 0.05 mm), p = 0.013. IMT statistical difference was no longer significant after Bonferroni correction.After Bonferroni correction, NIVE detected differences in CAT and CAS/CAT biomarkers in elevated BMI children, whereas IMT failed to show a difference. NIVE is a promising technique to monitor radiological biomarkers of subclinical atherosclerosis in the pediatric population.