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Carotid intima media thickness and arterial stiffness in children with acute rheumatic fever.
[acute rheumatic fever]
Acute
rheumatic
fever
(
ARF
)
and
rheumatic
heart
disease
(
RHD
)
constitute
important
public
health
problems
in
developing
countries
.
Inflammation
is
present
both
in
the
early
and
late
stages
of
the
diseases
.
Chronic
inflammation
is
known
to
be
associated
with
atherosclerosis
.
We
hypothesize
that
subclinical
atherosclerosis
and
arterial
stiffness
may
increase
due
to
the
ongoing
inflammation
as
well
as
the
increased
pulse
pressure
and
left-
ventricular
systolic
dysfunction
in
RHD
.
The
purpose
of
the
present
study
was
to
investigate
carotid
intima
media
thickness
(
CIMT
)
and
carotid
artery
stiffness
in
patients
with
ARF
.
Forty
patients
in
follow-up
due
to
ARF
in
the
age
group
of
7
-
16
Â
years
(
disease
duration
1
-
10
Â
years
)
and
36
volunteered
subjects
with
similar
body
mass
index
were
included
in
the
study
.
The
subjects
included
in
the
present
study
were
compared
regarding
M-
mode
echocardiographic
parameters
and
CIMT
as
well
as
carotid
arterial
strain
(
CAS
)
,
carotid
artery
distensibility
(
CAD
)
,
beta
stiffness
index
(
βSI
)
,
and
pressure-strain
elasticity
modulus
(
Ep
)
as
carotid
artery
stiffness
parameters
.
CIMT
(
0
.
52
Â
±
Â
0
.
08
and
0
.
48
Â
±
Â
0
.
07
Â
mm
,
p
Â
=
Â
0
.
01
)
,
βSI
(
5
.
29
Â
±
Â
2
.
98
and
3
.
02
Â
±
Â
1
.
30
,
p
Â
<
Â
0
.
001
)
,
and
Ep
(
426
.
53
Â
±
Â
210
.
50
and
254
.
44
Â
±
Â
104
.
69
p
Â
<
Â
0
.
001
)
were
increased
,
whereas
CAS
(
0
.
11
Â
±
Â
0
.
01
and
0
.
19
Â
±
Â
0
.
09
,
p
Â
<
Â
0
.
001
)
and
CAD
(
10
.
27
Â
±
Â
4
.
69
and
17
.
76
Â
±
Â
14
.
41
,
p
Â
<
Â
0
.
001
)
were
decreased
in
patients
with
ARF
compared
with
the
control
group
.
There
was
a
positive
correlation
between
pulse
pressure
and
βSI
(
r
Â
=
Â
0
.
25
,
p
Â
=
Â
0
.
02
)
and
Ep
(
r
Â
=
Â
0
.
28
,
p
Â
=
Â
0
.
01
)
in
addition
to
a
correlation
between
left
atrial
dilatation
and
CIMT
(
r
Â
=
Â
0
.
55
p
Â
<
Â
0
.
001
)
in
patients
with
ARF
.
CIMT
and
carotid
artery
stiffness
were
increased
in
patients
with
ARF
.
Patients
with
ARF
may
have
an
increased
risk
of
subclinical
atherosclerosis
and
cardiovascular
events
.
Diseases
Validation
Diseases presenting
"increased risk of subclinical atherosclerosis and cardiovascular events"
symptom
acute rheumatic fever
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