Change in the aortic pulse wave velocity in children with familial hypercholesterolemia

Background. Familial hypercholesterolemia (FH) is the genetic disease characterized by an increase in the levels of total cholesterol and low density lipoproteins since childhood.
The aim of the study was to assess arterial stiffness in children with heterozygous FH by measuring pulse wave velocity (PWV) in the aorta.
Design and methods. The study involved 118 children. Of these, 60 healthy children were in the control group and 58 children with the diagnosis of heterozygous FH were included in the main group. Both groups were divided into 3 age subgroups: from 5 to 7 years old, from 8 to 12 years old and from 13 to 17 years old. The diagnosis of FH was made according to the British criteria by Simon Broome. The lipid profile was determined for all children, blood pressure was monitored daily with the estimate of the minimum, average and maximum PWV (PWVmin, PWVav, PWVmax) in aorta using oscillometric method.
Results. In the younger age subgroup (5–7 years), there were no significant differences in PWV between main and control groups. In children aged 8–12 years, the main group was characterized by significantly higher values of maximum PWV compared to healthy peers — 5,1 [4,7–5,8] and 4,6 [4,45–5,05] m/s, respectively (p = 0,041). In group of children with FH aged 13–17 years, compared to the control group, a significant increase in the minimum PWV was observed — 4,7 [4,1–5,1] and 3,9 [3,5–4,1] m/s, respectively (p = 0,009), average PWV — 5,5 [4,8–6,4] and 4,5 [4,2–4,9] m/s, respectively (p = 0,009), and maximum PWV — 6,2 [5,7–7,55] and 5,4 [5,05–5,6] m/s, respectively (p = 0,007). Correlation analysis in patients with FH showed direct correlation between PWVmin, PWVav and PWVmax with total cholesterol (r = 0,46, r = 0,46 and r = 0,464, respectively, p < 0,001).
Conclusions. Our study demonstrates an increase in the PWV in the aorta in children with FH compared with healthy peers from 8–12 years of age. There is a further progression of arterial stiffness with an increase in the minimum, average and maximum PWV most significant in the group of 13–17 years.

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