Brachial artery flow-mediated dilation is less repeatable in children with a chronic inflammatory disease compared to their healthy peers

Abstract

Background

Children with a chronic inflammatory disease (CID) are at increased risk of cardiovascular disease and show an impaired flow-mediated dilation (FMD) response compared to their healthy peers, making it critical to monitor their cardiovascular health over time. FMD is a repeatable measure of vascular function in healthy children and adults. However, repeatability can vary in adult populations with disease and inflammation, and the repeatability of FMD in children with a CID has not been explored.

Objectives

The objective of this study was to assess the repeatability of brachial artery FMD in children with a CID and their healthy peers.

Methods

Participants with CID, including cystic fibrosis, inflammatory bowel disease, juvenile idiopathic arthritis, or type 1 diabetes (n = 52; age: 14.1 ± 2.1 years; sex: 48% F) and healthy controls (n = 21; age: 12.3 ± 2.7 years; sex: 48% F), underwent two FMD assessments. Repeatability was assessed using intraclass correlation coefficients (ICCs) and coefficients of variation (CVs) for BLD, absolute FMD, and relative FMD.

Results

BLD was repeatable in both our CID and healthy control groups (CV < 2.0%, ICC > 0.90). Relative FMD was repeatable in healthy controls with a CV of 10.0 ± 5.8% and an ICC of 0.86. However, it was not repeatable in children with a CID, with a CV of 18.8 ± 16.3% and an ICC of 0.52.

Conclusion

FMD is less repeatable in children with a CID, and our findings of a large CV for relative FMD suggest that measurement error could be a challenge to reliably tracking changes in FMD over time in this paediatric population.