The place of pulse wave velocity as an indicator of early cardiac damage in children with chronic hypertension

İntroduction There has been a significant increase in the prevalence of HT in children and adolescents in recent years. High blood pressure tends to range from childhood to adulthood. Childhood HT has become a widely researched topic in the last decade due to its increasing prevalence. Even mildly high blood pressure has a negative effect on target organs such as blood vessels, heart, brain, kidney and retina. Especially in children, evaluation of subclinical end organ damage due to HT is useful to prevent future cardiovascular diseases. Recognizing high-risk populations at an early age may provide an opportunity to reduce target organ damage. In this study, we aimed to study the relationship between arterial stiffness measurement and ECHO measurements in children with chronic hypertension. In addition, we aimed to investigate whether cardiac involvement as target organ damage can be detected by arterial stiffness measurement, which is easy and non-invasive in these patients. Materials and Methods Between December 1, 2018 and December 1, 2019, children aged 5-18 years who were admitted to the ADU pediatric nephrology outpatient clinic with a diagnosis of chronic HT (who had HT for at least 3 months) or who were being followed up, and healthy children of the same age and sex were included in the study. For the evaluation of arterial stiffness, measurements of all children included in the study were made with the Mobil-O-graph device by oscillometric method. Blood was drawn from all participants after 12 hours of fasting and serum type 1 procollagen carboxyterminal propeptide (T1PKTP) level was measured. In addition, each participant's left ventricular mass index (LVMI), carotid intima-media thickness (CIMT) and myocardial global strain values were measured with an Echocardiography (ECHO) device. A data follow-up form was filled in for each child. Results In our study, only the BM and BMI values among the demographic data were found to be higher in the HT group compared to the control group. Among the arterial stiffness measurements, many parameters (PWV, peripheral SBP / DBP, MAP, central SBP / DBP, PP and KO) were found to be higher in the hypertension group compared to the control group. However, there was no significant difference between the groups in terms of arterial stiffness parameters such as augmentation index, augmentation pressure and projection size. In addition, in our study, in the hypertension and control group; peripheral SBP was significantly higher than central SBP, and central DBP compared to peripheral SBP. In the hypertension group, many parameters (CIMT, LVMI, IVSd and LVPWd) were found to be significantly higher than the control group. Also, from arterial stiffness measurements; a positive correlation was found between PWV and ECHO parameters between carotid intima-media thickness, left ventricular mass index, left ventricular end-diastolic intraventricular septum thickness, left ventricular end-diastolic diameter and left ventricular end-diastolic posterior wall thickness. However, no significant relationship was found between these parameters in the control group. In addition, there was no significant difference between the groups in terms of strain parameters measured by Speckle Tracking ECHO and serum T1PKTP levels measured by ELISA method. Conclusion We think that the evaluation of arterial stiffness and measured NDH, which is used practically and noninvasively in the clinic, is an important evaluation that provides information about the vascular structure in children with hypertension. In addition, we think that AS-NDH measurement can be used to show the effect of the heart as target organ damage even in the early period of hypertension in children. Multi-center and comprehensive studies should be conducted on this subject.