Carotid Intima–Media Thickness in Children and Adolescents With Congenital Heart Disease

Background: With increased long-term survival, children with congenital heart disease (CHD) are at increased risk of early-onset adult cardiovascular disease. Carotid intima–media thickness (cIMT) is a surrogate marker of atherosclerosis. The aim of this present study was to detect high-risk diagnostic subgroups by measuring cIMT and determine its correlates in children with CHD and subgroups of CHD compared with healthy controls. Methods: This cross-sectional study enrolled 385 patients (138 girls) aged 5 to 18 years (12.3 ± 3.3) who were recruited between May 2015 and June 2017. cIMT was measured using B-mode ultrasound. Height, weight, body mass index, age, mean arterial pressure, pulse-wave velocity, and central systolic blood pressure were assessed as possible risk factors. For subgroup analyses, the patients were divided according to the type of their heart defects. Furthermore, patient data were compared with 86 healthy controls (35 girls, 12.8 ± 2.5 years) measured in the same time frame with identical ultrasound protocol. Results: Patients with CHD showed higher cIMT values (cIMT = 0.464 ± 0.039 mm) than healthy controls (cIMT = 0.449 ± 0.045 mm; P = 0.003), even after adjusting for sex, age, height, and weight differences. The highest cIMT values were found in children with coarctation of the aorta (cIMT = 0.486 ± 0.040 mm; P < 0.001) and transposition of the great arteries after arterial switch (cIMT 0.488 ± 0.041 mm; P < 0.001). No correlation was detected between cIMT and mean arterial pressure or pulse-wave velocity, but with central systolic blood pressure (P = 0.015; r = 0.150). Conclusions: Children with CHD have increased cIMT compared with healthy controls, particularly those with coarctation of aorta and transposition of the great arteries.