Feasibility of Very-high Resolution Ultrasound to Assess Elastic and Muscular Arterial Wall Morphology in Adolescents Attending an Outpatient Clinic for Obesity and Lipid Abnormalities

Objective: Atherosclerosis begins during early life and is accelerated in individuals with cardiovascular risk factors. We hypothesized that very-high resolution ultrasound (VHRU, 25-55 MHz) could feasibly detect early arterial changes in adolescents with risk factors.

Methods: We prospectively imaged the carotid, brachial and radial arterial morphology (far wall intima-media thickness, IMT; adventitia thickness, AT) by VHRU in 58 youths (age 14 ± 2 years) attending a Pediatric Preventive Cardiology Clinic for assessment and management of cardiovascular risk factors and compared the findings to those from an age-matched group of 67 controls.

Results: Brachial and radial imaging was successful for all subjects. The carotid far wall could not be imaged in 7% of the patients due to limitations in penetration. VHRU image quality was related to body size and imaging depth. Imaging and analysis time were 12 ± 3 and 18 ± 3 min, respectively. Carotid IMT was increased in patients (0.42 ± 0.05 vs. 0.40 ± 0.06 mm, p = 0.05). No differences were found in brachial or radial IMT or AT vs. controls. Age, male gender, body mass index, systolic blood pressure (BP), but not lipid levels, were associated with arterial IMT in regression analyses.

Conclusion: VHRU is feasible in imaging carotid and peripheral muscular artery IMT in adolescents. The arterial IMT is associated with age, gender, adiposity and systolic BP, but not lipid levels, in this adolescent population. Further studies including patients with manifest clinical atherosclerosis are needed to assess if VHRU has applications in atherosclerosis research.