Feasibility Of Brachial-femoral Pulse Wave Velocity In Young Children And Comparability To Normative Data

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Cardiovascular (CV) disease progression occurs across the lifespan. However, available measures of CV risk in early childhood are limited. Carotid-femoral pulse wave velocity (cfPWV) is a gold-standard, non-invasive measure of subclinical CV health. Previous studies demonstrate feasibility of cfPWV measurement in children ages 6-19 but have not included younger children, a population who may pose unique challenges. Brachial-femoral PWV (bfPWV) is less obtrusive, may be feasible to obtain, and could provide similar CV risk assessment to cfPWV in younger children. PURPOSE: 1) Determine the feasibility of bfPWV measurement in children ages 2-4 years; and 2) Assess the mean difference of observed bfPWV from age-predicted cfPWV from a published meta-regression in older children. METHODS: bfPWV was measured using the Vicorder® System (SMT Medical, Wuerzburg, Germany) in 8 children (mean 3.0±0.5 years). Oscillometric cuffs were placed on the right upper thigh and upper arm. Children were asked to rest in a semi-reclined chair for 5 minutes and given the choice to read or watch a video. Cuffs were inflated to a sub-diastolic (60 mmHg) pressure three times, with one minute between measures. After stabilization, bfPWV was captured across 3-5 heart cycles and averaged across measures. Age-predicted cfPWV were calculated using the formula 3.61+(0.12 x age) from previously published normative data. Differences between observed bfPWV and age-predicted cfPWV were summarized. RESULTS: We successfully obtained three high quality bfPWV scans on all 8 children. Mean bfPWV of 4.33 ± 0.49 m/s (range: 3.77-5.20) was not different from the age-predicted cfPWV of 4.00 ± 0.06 (mean difference: 0.33 m/s, 95% CI: -0.04, 0.71), suggesting agreement. Observed bfPWV and predicted cfPWV by age are presented in the Figure. CONCLUSION: bfPWV appears to be useful tool for assessing subclinical CV risk in children ages 2-4 years with high feasibility and good agreement to normative data.