Evaluation of pulse wave velocity as early indicator of vascular damage in children and adolescents with heterozygous familial hypercholesterolemia

Patrizia Bruzzi; Francesco Candia; Laura Lucaccioni; Madeo Simona Filomena; Viola Trevisani; Anna Insalaco; Angela Giandomenico; Barbara Predieri; Lorenzo Iughetti

doi:10.1530/endoabs.110.P762

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Endocrine Abstracts (2025) 110 P762 | DOI: 10.1530/endoabs.110.P762

ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)

Evaluation of pulse wave velocity as early indicator of vascular damage in children and adolescents with heterozygous familial hypercholesterolemia

Patrizia Bruzzi ¹ , Francesco Candia ¹ , Laura Lucaccioni ² , Simona Filomena Madeo ¹ , Viola Trevisani ² , Anna Insalaco ² , Angela Giandomenico ² , Barbara Predieri ² & Lorenzo Iughetti ²

Author affiliations

¹Azienda Opedaliero-Universitaria di Modena, Policlinico, University of Modena and Reggio Emilia, Modena, Italy, Department of Medical and Surgical Sciences of the Mother, Children and Adults, Modena, Italy; ²University of Modena and Reggio Emilia, Department of Medical and Surgical Sciences of the Mother, Children and Adults, Modena, Italy

JOINT2866

Background: In recent years, pulse wave velocity (PWV) becomes a simple, non-invasive, reliable and reproducible method for determining arterial stiffness. In adults, PWV is already a well-established predictor of cardiovascular disease (CVD) and, recently, it has been used also in childhood. Children with heterozygous familial hypercholesterolemia (heFH) are at risk of premature atherosclerosis. Aims of this study were: (a) to evaluate PWV in a group of children and adolescents affected by heFH in comparison to internationally established age-specific references (1, 2), and (b) to identify predictive negative factors influencing PWV in the same cohort of patients.

Methods: This is descriptive and cross-sectional study. Physical examination, plasma lipid profile and PWV were measured in all patients at diagnosis of heFH (all untreated). PWV was measured with an oscillometric device (Vicorder). Values of PWV above the 95th percentiles were classified as elevated (1, 2).

Results: In heFH children (n. 22, 10 males, mean age 9.60±4.15 years, mean total cholesterol 306.54±32.66 mg/dl, LDL-cholesterol 218.28±41.52 mg/dl, BMI-SDS 0.21±1.14 kg/m², meansystolic blood pressure percentile 49.09±38.83), mean PWV was 4.52±0.65 m/s (range 3.50-5.80 m/s) and did not differ between gender (girls vs. boys: PWV 4.30±0.54 vs. 4.79±0.70 m/s, p 0.09; age 8.87±4.88 vs 10.47±3.16 years, p 0.24; systolic blood pressure percentile 53.83±34.54 vs. 43.40±44.63, p 0.40). According to international references (1, 2), the prevalence of elevated pulse wave velocity was 32% (7/22; 2 females). Moreover, PWV positively correlated with systolic blood pressure (R 0.43, p <0.05), mainly in males (R 0.81, p <0.05).

Conclusions: In literature, data on PWV in heFH children and adolescents are still scarce. Our study supports that arterial stiffness occurs early and more frequent in asymptomatic heFH children indicating a subclinical increased risk for premature CVD and reflecting the need for early initiation of anti-cholesterolemic treatment. Moreover, our data point out that, even during the first decades of life, not only hypercholesterolemia, but also clusters of pro-atherogenic conditions, such as hypertension, could affect PWV.

References: 1. Stoner L, Kucharska-Newton A, Meyer ML. Cardiometabolic Health and Carotid-Femoral Pulse Wave Velocity in Children: A Systematic Review and Meta-Regression. J Pediatr 2020;218:98-105.e3.

2. Fischer DC, Schreiver C, Heimhalt M, Noerenberg A, Haffner D. Pediatric reference values of carotid-femoral pulse wave velocity determined with an oscillometric device. J Hypertens 2012;30:2159–2167.