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Erschienen in:

05.08.2023 | Review

Normal pediatric values of carotid artery intima-media thickness measured by B-mode ultrasound and radiofrequency echo tracking respecting the consensus: a systematic review

verfasst von: Jean-Baptiste Moretti, Reinemary Michael, Sylvie Gervais, Émilie Alchourron, Nina Stein, Ziad Farhat, Chantal Lapierre, Josée Dubois, Ramy El-Jalbout

Erschienen in: European Radiology | Ausgabe 1/2024

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Abstract

Background

Carotid artery intima-media thickness (IMT) is a sub-clinical radiologic marker of atherosclerosis in children. It is associated with adult-onset vascular disease.

Objective

To determine normal pediatric values of IMT from results observed in the literature.

Methods

Our systematic review was conducted according to PRISMA guidelines. We reviewed 2298 English articles from inception to February 2023. Inclusion criteria included studies evaluating B-mode and radiofrequency (RF)-based IMT measurements based on the American Heart Association, the Association for European Pediatric Cardiology, the Mannheim Consensus, and the American Society of Echocardiography recommendations. A meta-analysis of aggregate data was conducted to obtain the confidence interval (CI) for IMT, using a 95% confidence level.

Results

We obtained 88 B-mode-based IMT measurement studies with 6184 children and six radiofrequency echo-tracking-based studies with 766 children. Mean IMT in the pediatric population was 0.43 mm, 95% [CI] 0,42 to 0.44, using the B-mode technique, and 0.41 mm, 95% [CI] 0.36 to 0.45 using the radiofrequency technique. No significant relationship was detected between IMT and age (p value = 0.83). Finally, no significant effect of sex on IMT was found (p value = 0.82 for B-mode and p value = 0.62 for RF).

Conclusion

Based on the studies selected in this literature review, we were unable to conclude that there was a significant difference between the average IMT of boys and girls. No relationship was demonstrated between age and IMT. IMT is technique-specific, and normal values should be interpreted according to recommendations of recognized consensus to counteract the current heterogeneity in literature.

Clinical relevance statement

Technique and children-specific Intima media thickness measurements help clinicians and scientists to assess the risk of atherosclerosis in children.

Key Points

• Intima-media thickness (IMT) does not correlate with age in children without risk factors.
• According to current literature, there is no difference in IMT between healthy boys and girls.
• There is heterogeneity, even with studies abiding by the official consensus.
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Literatur
1.
Zurück zum Zitat McGill HC Jr, McMahan CA, Zieske AW et al (2000) Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol 20(8):1998–2004 McGill HC Jr, McMahan CA,  Zieske AW  et al (2000) Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol 20(8):1998–2004
2.
Zurück zum Zitat Raitakari OT, Juonala M, Rönnemaa T (2008) Cohort profile: the cardiovascular risk in Young Finns Study. Int J Epidemiol 37(6):1220–6 Raitakari  OT, Juonala M, Rönnemaa T (2008) Cohort profile: the cardiovascular risk in Young Finns Study. Int J Epidemiol 37(6):1220–6
3.
Zurück zum Zitat Baker JL, Olsen LW, Sørensen TI (2007) Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med 357(23):2329–37CrossRefPubMedPubMedCentral Baker JL, Olsen LW, Sørensen TI (2007) Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med 357(23):2329–37CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Roger VL, Go AS, Lloyd-Jones DM (2012) Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation 125(1):e2–e220 Roger VL, Go AS, Lloyd-Jones DM (2012) Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation 125(1):e2–e220
5.
Zurück zum Zitat Cloutier G, Cardinal M-HR et al (2018) Carotid artery intima-media thickness measurement in children with normal and increased body mass index: a comparison of three techniques. Pediatr Radiol 48(8):1073–1079 Cloutier G, Cardinal M-HR  et al (2018) Carotid artery intima-media thickness measurement in children with normal and increased body mass index: a comparison of three techniques. Pediatr Radiol 48(8):1073–1079
6.
Zurück zum Zitat Touboul PJ, Hennerici MG, Meairs S et al (2006) (2007) Mannheim carotid intima-media thickness consensus (2004–2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium. Cerebrovasc Dis 23(1):75–80 Touboul PJ, Hennerici MG, Meairs S et al (2006) (2007) Mannheim carotid intima-media thickness consensus (2004–2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium. Cerebrovasc Dis 23(1):75–80
7.
Zurück zum Zitat Dalla Pozza R, Ehringer-Schetitska D, Fritsch P et al (2015) Intima media thickness measurement in children: a statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology. Atherosclerosis 238(2):380–7 Dalla Pozza R, Ehringer-Schetitska D, Fritsch P et al (2015) Intima media thickness measurement in children: a statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology. Atherosclerosis 238(2):380–7
8.
Zurück zum Zitat Urbina EM, Williams RV, Alpert BS et al (2009) Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension. 54(5):919–50 Urbina EM, Williams RV, Alpert BS et al (2009) Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension. 54(5):919–50
9.
Zurück zum Zitat Stein JH, Korcarz CE, Todd Hurst R et al (2008) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr, 21(2): p. 93-111; quiz 189-90 Stein JH, Korcarz CE, Todd Hurst R et al (2008) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr, 21(2): p. 93-111; quiz 189-90
10.
Zurück zum Zitat Schreuder FH, Graf M, Hameleers JM , Mess JM, Hoeks AP (2009) Measurement of common carotid artery intima-media thickness in clinical practice: comparison of B-mode and RF-based technique. Ultraschall Med 30(5):459–65 Schreuder FH, Graf M, Hameleers JM , Mess JM, Hoeks AP (2009) Measurement of common carotid artery intima-media thickness in clinical practice: comparison of B-mode and RF-based technique. Ultraschall Med 30(5):459–65
11.
Zurück zum Zitat El Jalbout R, Cloutier G, Roy-Cardinal M-H et al (2019) The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese children. Eur Radiol 29(7):3854–3861 El Jalbout R, Cloutier G, Roy-Cardinal M-H  et al (2019) The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese children. Eur Radiol 29(7):3854–3861
12.
Zurück zum Zitat Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71 Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71
13.
Zurück zum Zitat Langan D (2022) Assessing heterogeneity in random-effects meta-analysis. Methods Mol Biol 2345:67–89CrossRefPubMed Langan D (2022) Assessing heterogeneity in random-effects meta-analysis. Methods Mol Biol 2345:67–89CrossRefPubMed
14.
Zurück zum Zitat von Hippel PT (2015) The heterogeneity statistic I(2) can be biased in small meta-analyses. BMC Med Res Methodol 15:35CrossRef von Hippel PT (2015) The heterogeneity statistic I(2) can be biased in small meta-analyses. BMC Med Res Methodol 15:35CrossRef
15.
Zurück zum Zitat Dettori JR, Norvell DC, Chapman JR (2021) Seeing the forest by looking at the trees: how to interpret a meta-analysis forest plot. Global Spine J 11(4):614–616CrossRefPubMedPubMedCentral Dettori JR, Norvell DC, Chapman JR (2021) Seeing the forest by looking at the trees: how to interpret a meta-analysis forest plot. Global Spine J 11(4):614–616CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Juonala M, Kähönen M, Laitinen T et al (2008) Effect of age and sex on carotid intima-media thickness, elasticity and brachial endothelial function in healthy adults: the cardiovascular risk in Young Finns Study. Eur Heart J 29(9):1198–206 Juonala M, Kähönen M, Laitinen T et al (2008) Effect of age and sex on carotid intima-media thickness, elasticity and brachial endothelial function in healthy adults: the cardiovascular risk in Young Finns Study. Eur Heart J 29(9):1198–206
17.
Zurück zum Zitat Buljan K, Soldo SB, Janculjak D et al (2015) Relationship between Age and Thickness of Carotid Arteries in a Population without Risk Factors for Atherosclerosis. Coll Antropol 39(3):779–84 Buljan K, Soldo SB, Janculjak D et al (2015) Relationship between Age and Thickness of Carotid Arteries in a Population without Risk Factors for Atherosclerosis. Coll Antropol 39(3):779–84
18.
Zurück zum Zitat Maurice RL, Soulez G, Giroux M-F, Cloutier G (2008) Noninvasive vascular elastography for carotid artery characterization on subjects without previous history of atherosclerosis. Med Phys 35(8):3436–43 Maurice RL, Soulez G, Giroux M-F, Cloutier G (2008) Noninvasive vascular elastography for carotid artery characterization on subjects without previous history of atherosclerosis. Med Phys 35(8):3436–43
19.
Zurück zum Zitat Sass C , Herbeth B, et al (1998) Intima-media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: effect of age, sex, anthropometry and blood pressure. J Hypertens 16(11):1593–602 Sass  C , Herbeth B, et al (1998) Intima-media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: effect of age, sex, anthropometry and blood pressure. J Hypertens 16(11):1593–602
20.
Zurück zum Zitat Calabrò MP, Carerj S, Russo MS (2017) Carotid artery intima-media thickness and stiffness index β changes in normal children: role of age, height and sex. J Cardiovasc Med (Hagerstown) 18(1):19–27 Calabrò MP, Carerj S, Russo MS (2017) Carotid artery intima-media thickness and stiffness index β changes in normal children: role of age, height and sex. J Cardiovasc Med (Hagerstown) 18(1):19–27
21.
Zurück zum Zitat Gooty VD, Sinaiko AR, Ryder JR, Dengel DR, Jacobs Jr DR , Steinberger J (2018) Association between carotid intima media thickness, age, and cardiovascular risk factors in children and adolescents. Metab Syndr Relat Disord 16(3):122–126  Gooty VD, Sinaiko  AR, Ryder  JR, Dengel  DR,  Jacobs Jr  DR , Steinberger J (2018) Association between carotid intima media thickness, age, and cardiovascular risk factors in children and adolescents. Metab Syndr Relat Disord 16(3):122–126
22.
Zurück zum Zitat van der Heyden JC, Birnie E, Bovenberg SA et al (2016) Do traditional cardiovascular risk factors solely explain intima-media thickening in youth with type 1 diabetes? J Diabetes Complications 30(6):1137–43 van der Heyden JC,  Birnie E, Bovenberg SA et al (2016) Do traditional cardiovascular risk factors solely explain intima-media thickening in youth with type 1 diabetes? J Diabetes Complications 30(6):1137–43
23.
Zurück zum Zitat Baroncini LA, Sylvestre de Castro L, Pecoits Filho R (2016) Assessment of intima-media thickness in healthy children aged 1 to 15 years. Arq Bras Cardiol 106(4): 327-32 Baroncini LA, Sylvestre de Castro L, Pecoits Filho R (2016) Assessment of intima-media thickness in healthy children aged 1 to 15 years. Arq Bras Cardiol 106(4): 327-32
24.
Zurück zum Zitat Howard G, Sharrett AR, Heiss G, et al (1993) Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 24(9):1297–304 Howard G, Sharrett AR, Heiss G, et al (1993) Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 24(9):1297–304
25.
Zurück zum Zitat Garcia J, Benedeti ACGS, Caixe SH, Mauad F, Nogueira-de-Almeida CA (2019) Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children. J Vasc Bras 18:e20190003 Garcia J, Benedeti ACGS, Caixe SH,  Mauad  F,  Nogueira-de-Almeida CA (2019) Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children. J Vasc Bras 18:e20190003
26.
Zurück zum Zitat Madhloum N, Luyten LJ, Provost EB et al (2020) Establishing reference values for macro- and microvascular measurements in 4-to-5 year-old children of the ENVIRONAGE prospective birth cohort. Sci Rep 10(1):5107 Madhloum N, Luyten  LJ,  Provost EB et al (2020) Establishing reference values for macro- and microvascular measurements in 4-to-5 year-old children of the ENVIRONAGE prospective birth cohort. Sci Rep 10(1):5107
27.
Zurück zum Zitat Craig A, Mels CMC, Aletta E Schutte AE , Tsikas D, Kruger R (2020) Nitric oxide-related markers link inversely to blood pressure in black boys and men: the ASOS and African-PREDICT studies. Amino Acids 52(4):639–648 Craig  A,  Mels  CMC, Aletta E Schutte AE , Tsikas  D, Kruger R (2020) Nitric oxide-related markers link inversely to blood pressure in black boys and men: the ASOS and African-PREDICT studies. Amino Acids 52(4):639–648
28.
Zurück zum Zitat Pinto FF, Gomes I, Loureiro P, Laranjo S, Timóteo AT, Carmo MM (2017) Vascular function long term after Kawasaki disease: another piece of the puzzle? Cardiol Young 27(3):488–497 Pinto  FF, Gomes  I, Loureiro P,  Laranjo S, Timóteo AT,  Carmo MM (2017) Vascular function long term after Kawasaki disease: another piece of the puzzle? Cardiol Young 27(3):488–497
29.
Zurück zum Zitat Rodrigues TMB, Barra CB, Filgueiras MFTF, Silva IN (2019) Intima-media thickness of the carotid arteries is affected by pubertal maturation in healthy adolescents. Rev Paul Pediatr 37(4):428–434 Rodrigues TMB, Barra CB, Filgueiras MFTF, Silva IN (2019) Intima-media thickness of the carotid arteries is affected by pubertal maturation in healthy adolescents. Rev Paul Pediatr 37(4):428–434
30.
Zurück zum Zitat Torkar AD, Plesnik E, Groselj U, Battelino B, Kotnik P (2020) Carotid intima-media thickness in healthy children and adolescents: normative data and systematic literature review. Front Cardiovasc Med 7:597768 Torkar  AD, Plesnik  E, Groselj U, Battelino B, Kotnik P (2020) Carotid intima-media thickness in healthy children and adolescents: normative data and systematic literature review. Front Cardiovasc Med 7:597768
31.
Zurück zum Zitat Semmler L, Weberruß H, Baumgartner L, Pirzer R, Oberhoffer-Fritz R (2021) Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children. Eur J Pediatr 180(3):851–860 Semmler L, Weberruß H, Baumgartner L, Pirzer R, Oberhoffer-Fritz R (2021) Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children. Eur J Pediatr 180(3):851–860
32.
Zurück zum Zitat Ryder JR, Dengel DR, Jacobs Jr DR, Sinaiko AR, Kelly AS, Steinberger J (2016) Relations among adiposity and insulin resistance with flow-mediated dilation, carotid intima-media thickness, and arterial stiffness in children. J Pediatr 168:205–211 Ryder  JR, Dengel  DR, Jacobs Jr  DR, Sinaiko  AR, Kelly AS,  Steinberger  J (2016) Relations among adiposity and insulin resistance with flow-mediated dilation, carotid intima-media thickness, and arterial stiffness in children. J Pediatr 168:205–211
Metadaten
Titel
Normal pediatric values of carotid artery intima-media thickness measured by B-mode ultrasound and radiofrequency echo tracking respecting the consensus: a systematic review
verfasst von
Jean-Baptiste Moretti
Reinemary Michael
Sylvie Gervais
Émilie Alchourron
Nina Stein
Ziad Farhat
Chantal Lapierre
Josée Dubois
Ramy El-Jalbout
Publikationsdatum
05.08.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 1/2024
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-09994-2

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