Abnormalities of Vascular Structure and Function in Children With Perthes Disease


Perry, DC; Green, DJ; Bruce, CE; Pope, D; Dangerfield, P; Platt, MJ; Hall, AJ; Jones, H; (2012) Abnormalities of Vascular Structure and Function in Children With Perthes Disease. Pediatrics, 130 (1). E126-E131. ISSN 0031-4005 DOI: 10.1542/peds.2011-3269

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Abstract

BACKGROUND AND OBJECTIVES: Perthes disease is a childhood precipitant to osteoarthritis of the hip, for which the etiology and mechanism are unknown. There is mounting evidence to suggest a vascular insult is responsible for disease, and it is suggested that this may have long-term implications for the vascular health of affected individuals. This study sought to use ultrasound measures to investigate vascular structure and function in children affected by Perthes disease. METHODS: This case control study encompassed 149 cases and 146 controls, frequency matched for age and gender. Endothelial function was measured by using the technique of flow-mediated dilation of the brachial artery, and alterations in arterial flow were recorded in response to an ischemic stimulus. RESULTS: There was a significant structural alteration in the vasculature among individuals with Perthes disease (resting brachial artery diameter (cases 2.97 mm versus controls 3.11 mm; P = .01), which remained even after adjusting for height. In addition, there was a notable reduction in blood velocity (cases 33.84 cm/s versus controls 37.83 cm/s; P = .01) and blood flow (cases 149.82 mL/min versus controls 184.67 mL/min; P = .001), which was independent of baseline arterial size. There was no evidence to suggest that flow-mediated dilation of the brachial artery was impaired among affected individuals (P = .71). CONCLUSIONS: Children with Perthes disease exhibit small artery caliber and reduced function, which is independent of body composition. These data imply that that Perthes disease may reflect a wider vascular phenomenon that could have long-term implications for the vascular health of affected individuals. Pediatrics 2012;130:e126-e131

Item Type: Article
Keywords: Legg-Perthes disease, etiology, risk factors, flow-mediated dilation, spontaneously hypertensive-rats, incident, cardiovascular events, endothelial function, femoral-head, passive, smoking, adults, risk, atherosclerosis, thrombophilia, Adolescent, Blood Flow Velocity, Body Height, Brachial Artery, pathology, physiopathology, ultrasonography, Case-Control Studies, Child, Child, Preschool, Female, Humans, Legg-Calve-Perthes Disease, pathology, physiopathology, ultrasonography, Logistic Models, Male, Multivariate Analysis, Ultrasonography, Doppler
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 22665417
Web of Science ID: 305905900017
URI: http://researchonline.lshtm.ac.uk/id/eprint/251194

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