Abstract
Objective
Familial hypercholesterolemia (FH) impairs macrovascular endothelial function in childhood
and causes an increase of cardiovascular risk in later life. Whether microvascular
function is affected in children with FH is unknown. The aim of this study was to
investigate the impact of FH on microvascular autoregulation in children by post occlusive
reactive hyperemia (PORH).
Methods
PORH of the skin was assessed using laser Doppler fluxmetry. Baseline perfusion, biological
zero, defined as no-flow laser Doppler signal during suprasystolic occlusion, peak
perfusion after release of suprasystolic occlusion, as well as time to peak perfusion
and recovery time, defined as time until baseline perfusion is resumed, were measured
in 16 children, who were diagnosed with FH according to current guidelines, and in
91 healthy controls.
Results
In children with FH, peak perfusion was higher (FH: 1.60±0.68 vs. controls: 1.26±0.50 AU [arbitrary units], p=0.02), recovery time was longer (110±42.61 vs. 83.18±35.08 s, p=0.01) and biological zero was lower than in controls (0.12±0.04 vs. 0.18±0.05 AU, p<0.001). Baseline perfusion and time to peak were not different between children with
FH and controls (baseline perfusion: 0.43±0.21 vs. 0.38±0.15 AU, p=0.18; time to peak: 15.44±12.25 vs. 18.18±17.79 s, p=0.56).
Conclusion
For the first time the present study reveals an impact of FH on microvascular autoregulation
in children: the differences of PORH between children with FH and controls indicate
an affected autoregulation of microvascular blood flow in FH, which has its onset
in childhood.
Abbreviations:
AU (arbitrary units), BMI (body mass index), BMI-SDS (body mass index standard deviation score), FH (familial hypercholesterolemia), HDL (high density lipoprotein), LDL (low density lipoprotein), PORH (post occlusive reactive hyperemia)Keywords
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Article info
Publication history
Published online: January 28, 2013
Accepted:
December 22,
2012
Received:
October 22,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
