Aorta Stenosis, Bone Marrow Transplant, Cancer (Solid Tumors), Chronic Kidney Disease, Coarctation of Aorta, Dyslipaemia, Familial Hypercholesterolaemia, HIV Infection, Hypertension, Inflammatory Bowel Disease (IBD), Juvenile Idiopahtic Arthritis, Kawasaki Disease, Kidney Transplant, Leukemia, Lipoprotein(a), Liver Transplant, Lymphoma, Non Alcoholic Fatty Liver Disease, Obesity and Overweight, Pulmonary Hypertension, Systemic Lupus Erthematosus, Transposition of Great Arteries, Type 1 Diabetes Mellitus (T1DM), Type 2 Diabetes Mellitus (T2DM), White Coat Hypertension
Conditions
Keywords
cardiovascular risk, vasculature, children with chronic conditions
Brief summary
Children living with chronic health conditions face a higher risk of developing cardiovascular diseases than their peers, largely due to the accelerated aging of the heart and blood vessels. Although experts recognize this elevated risk and recommend close monitoring and early intervention, the underlying mechanisms driving this phenomenon remain poorly understood. At present, no effective interventions specifically target its root causes. Recent research shows that both large blood vessels (such as the carotid artery) and small vessels (such as those in the retina) can display early signs of damage decades before clinically apparent heart or vascular disease emerges. This accelerated vascular aging can result from multiple factors - including disease-related processes such as persistent inflammation and metabolic disturbances, treatment-related effects such as chemotherapy or long-term steroid use, and lifestyle changes associated with chronic illness, such as reduced physical activity and altered eating habits. However, it is still unclear how these factors influence the development and progression of vascular changes in children as they grow. Importantly, these changes can be monitored through non-invasive methods, offering a unique opportunity to study at-risk patients many years before overt cardiovascular disease develops. Identifying these early changes may enable us to detect and track individuals at heightened risk well in advance of clinical disease. This study aims to deepen our understanding of the causes of increased cardiovascular risk in children with chronic conditions and to lay the groundwork for earlier, more targeted prevention strategies.
Interventions
None listed
Sponsors
Semmelweis University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
6 Years to 25 Years
Healthy volunteers
No
Inclusion criteria
1. Individuals aged between 6 and 25 years; 2. Diagnosed with a chronic childhood condition/disease associated with an increased risk of early cardiovascular disease; 3. Provided informed consent (if over 18 years old) or had informed consent provided by their legal guardian (if under 18 years old) following appropriate information about the study. Chronic childhood conditions/diseases associated with increased risk of early cardiovascular disease are defined according to the 2019 American Heart Association recommendations (https://doi.org/10.1161/CIR.0000000000000618), as well as other conditions/diseases for which at least two large-scale epidemiological studies have demonstrated an increased risk of cardiovascular disease.
Exclusion criteria
1. Severe intellectual and developmental disability; 2. Decompensated heart failure; 3. Severe primary immunodeficiency; 4. Ongoing intravenous chemotherapy; 5. Infectious diseases posing a public health risk; or 6. History of regular alcohol or drug use.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Arterial stiffness | At baseline and at the time of annual follow-up | Assessed by carotid-femoral pulse wave velocity |
| Endothelial function of the brachial artery | At baseline and at the time of annual follow-up | Evaluated using flow-mediated dilation measured by ultrasound |
| Retinal vessel diameter | At baseline and at the time of annual follow-up | Assessed by static retinal vessel analysis |
| Retinal vessel fractal dimension and tortuosity | At baseline and at the time of annual follow-up | Assessed by static retinal vessel analysis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Endothelial function in capillaries | At baseline and at the time of annual follow-up | Assessed by flow-mediated dilation using laser speckle contrast imaging |
| Retinal neurovascular coupling | At baseline and at the time of annual follow-up | Assessed by dynamic retinal vessel analysis |
Countries
Hungary
Contacts
Primary ContactTamas Kiss, MD, PhD
Backup ContactBálint Mikes, MD, PhD
Outcome results
None listed