Abstract
Aim. To evaluate the association of Family History (FH) of cardiovascular diseases (CVD) in boys aged 12-13 years with the development of structural and functional changes in the left ventricle and stiffness of the main arteries in adulthood (43-46 years old) according to prospective study.Material and methods. For the initial examination, boys were selected whose parents suffered from CVD at a young age or died prematurely from them (risk group). The comparison group was formed from a population sample of boys of a similar age without FH of CVD. The examination included a survey on a standard questionnaire, measurement of anthropometric indicators, blood pressure (BP), pulse counting, determination of the blood lipid spectrum. The intima-media complex thickness (IMT) of the common carotid arteries was measured; echocardiography and applanation tonometry were performed.Results. The group with FH of CVD significantly (p<0.05) differed in childhood in terms of the body mass index (BMI) (18.8 vs 17.6 kg/m2), systolic BP (SBP) (117 vs 107 mm Hg), diastolic BP (DBP) (67 vs 56 mm Hg), average BP (81.8 vs 72.7 mm Hg) and triglycerides (0.79 vs 0.58 mmol/L). In adulthood, increased total cholesterol (TC) level (6.3 vs 5.8 mmol/L; p=0.036) and other indicators of atherogenesis were revealed in the risk group. The risk of fatal outcomes from CVD in the next 10 years in men with a family history of CVD in childhood was significantly higher compared to the control group (1.94 vs. 1.28; p <0.001). The main contribution to the total risk of fatal CVD in middle-aged men was made by TC and smoking. In the group with FH of CVD, higher stiffness of the arteries in adulthood was observed. There were found significant (p=0.002) intergroup differences in the IMT (0.73 vs 0.63 mm). A statistically significant positive relationship between BMI and some structural and functional indicators of the left ventricle and stiffness indicators of the main arteries was revealed. DBP and mean BP in childhood are associated with arterial stiffness in adulthood according to the parameters of central SBP and central DBP. BMI in boys is the most significant predictor for most structural and functional indicators of LV myocardial hypertrophy, in particular, LV myocardial mass (private R2=0.140) and interventricular septum thickness (R2=0.164; p=0.001), and arterial stiffness by central DBP parameter (R2=0.043; p=0.024) in adulthood. The risk of increased IMT development in males in adulthood with FH of CVD is 6.1 times higher than that of their peers without FH.Conclusion. FH of CVD revealed in childhood in males is a risk factor for the development of early atherosclerosis and, due to its ease of detection, can be used as one of the criteria for the formation of high-risk groups for the purpose of primary prevention.
Highlights
Олеся Юрьевна Исайкина1*, Вячеслав Борисович Розанов1, Александр Александрович Александров1, Ирина Викторовна Леонтьева2, Марина Борисовна Котова1, Елена Ильинична Иванова1
In adulthood, increased total cholesterol (TC) level (6.3 vs 5.8 mmol/L; p=0.036) and other indicators of atherogenesis were revealed in the risk group
The risk of fatal outcomes from cardiovascular diseases (CVD) in the 10 years in men with a family history of CVD in childhood was significantly higher compared to the control group (1.94 vs. 1.28; p
Summary
В 1990-1991 гг. сотрудниками отдела кардиологии НИИ педиатрии и детской хирургии были отобраны для первичного обследования мальчики, родители которых в молодом возрасте страдали ССЗ (коронарографически подтвержденный ИМ, артериальная гипертония, мозговой инсульт и др.), или преждевременно умерли от них (группа риска – группа 1). Группа сравнения (группа 2) была сформирована нами из популяционной выборки мальчиков аналогичного возраста без ОН по ССЗ. Также проводились измерение толщины КИМ общих сонных артерий (ОСА), эхокардиография и аппланационная тонометрия. Оценка КИМ ОСА проводилась методом ультразвукового сканирования магистральных сосудов шеи в В-режиме при параллельной записи ЭКГ. Измерение жесткости артериальной стенки проводилось методом аппланационной тонометрии с помощью прибора SphygmoCor (AtCor Medical, West Ryde, NSW, Australia). Для оценки прогностической значимости исходных (в детском возрасте) клинических характеристик в отношении структурно-функциональных показателей ЛЖ и показателей жесткости магистральных артерий во взрослом возрасте использовался простой и множественный линейный регрессионный анализ. Для выявления ассоциации ОН по ССЗ в детстве с ТИМ во взрослом возрасте применялся логистический регрессионный анализ с вычислением отношения шансов (ОШ; группу сравнения составляли лица мужского пола без ОН – ОШ=1,0). Что группа с ОН по ССЗ уже в детском возрасте статистически значимо отличалась по показателям ДАД, среднего
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