Assessment of epicardial adipose tissue volume and carotid intima-media thickness in children with primary arterial hypertension by magnetic resonance imaging

TL;DR

This study found that children with high blood pressure have more heart-related fat and thicker artery walls, suggesting early signs of heart disease.

Contribution

The study is the first to use MRI to link epicardial fat and carotid thickness in children with hypertension.

Findings

Hypertensive children had significantly higher epicardial adipose tissue volume than healthy controls.

Carotid intima-media thickness was also increased in children with primary arterial hypertension.

Epicardial adipose tissue volume was an independent predictor of carotid thickness.

Abstract

Epicardial adipose tissue (EAT) is a biologically active visceral brown adipose tissue, which is irregularly distributed across myocardium. It has emerged as a potential modifiable cardiometabolic biomarker in adults, demonstrating pro-inflammatory properties with involvement in subclinical atherosclerosis. The increased thickness of the inner two layers of the carotid artery wall (intima and media) in childhood can pose as a risk of the development of atherosclerotic disease and its complications in adult life, representing additional potential biomarker. The purpose of our study was to evaluate a relation between EAT volume (EATV) and carotid intima-media thickness (cIMT) in children and adolescents who have been diagnosed with primary arterial hypertension (AH), utilizing magnetic resonance imaging (MRI).

The study included 72 children and adolescents, half of them had an established diagnosis of primary AH and the other half were matched healthy controls. The EATV and cIMT measurements were compared between the two groups and correlated with clinical, anthropometric and functional parameters.

Children diagnosed with AH exhibited a significantly higher EATV (16.5 ± 1.9 cm3
vs. 10.9 ± 1.5 cm3; t = –13.815, p < 0.001) and higher cIMT (0.7 [0.2] mm vs. (0.4 [0.1) mm]; U = 54, p < 0.001) compared with their healthy counterparts. EATV demonstrated a significant correlation with cIMT.

Increased EATV and cIMT were found with MRI in hypertensive children compared to their healthy counterparts. EATV demonstrated a stronger association with hypertension than cIMT. EATV emerged as an independent predictor of cIMT.

Figures