Table 3.
Endo-PAT 2000 in paediatric patients with cardiac and vascular conditions (seven studies)
| Title, lead author | Year | Study design | Population: n=sample size, age; mean±SD or median (range),(F/M) | Control group: n=sample size, age; mean±SD or median (range),(F/M) | Results: RHI reported. if RHI not specified, we reported p/r values | Outcomes |
| Nocturnal blood pressure dipping as a marker of endothelial and cardiac function in pediatric-onset systemic lupus erythematosus (SLE). Chang et al8 | 2020 | Cross-sectional study—author contacted for separate paeds data | n=20, 9–19 years (mean 16.5), (7 were age 16 or under). Average disease duration 3.2 years (± 2.1).(F/M 17/3) | Separated into two groups based on nocturnal BP dipping status. | Mean RHI for n=7 (aged 16/under): 0.529. 22% had ED. Reduced diastolic BP dipping was associated with poorer endothelial function (r 0.5, p = 0.04). |
Isolated nocturnal BP non-dipping is associated with ED and atherosclerotic changes. Potential role for routine ABPM for youth with SLE. |
| Physiological changes in blood pressure (BP) impact peripheral endothelial function during adolescence. Deda et al90 | 2015 | Control study. Assessing association between RHI and known cardiovascular risk factors. |
n=90 healthy adolescents to assess normal RHI response, 14.2±1.91 years,(F/M 46/44). |
No controls | Mean arterial pressure significantly associated with RHI (p=0.01). Positive correlation RHI and age in women (r=0.33, p<0.02). RHI correlated with pubertal status: men (r=0.411, p=0.03), women (r=0.36, p=0.03). |
Physiological changes in BP significantly impact RHI results. |
| Endothelial function and arterial stiffness relate to functional outcomes in adolescent and young adult fontan survivors. Goldstein et al91 | 2016 | Cross-sectional prospective observational study | n=60, 8–25 years (mean 13.9±4.1),(F/M 29/31) | No controls | PAT derived baseline pulse amplitude (p<0.05) negatively associated with minute ventilation to C02 ratio. RHI 1.2 (0.2–4.8). | Worse vascular measures associated with worse functional measures. Increased arterial stiffness and decreased endothelial function are associated with lower aerobic capacity, physical activity, and QOL in Fontan survivors. |
| Natural history of vascular function in adolescent and young adult Fontan survivors: A longitudinal assessment of endothelial function and arterial stiffness. Goldstein et al92 | 2017 | Prospective single-centre longitudinal study, conference abstract. Paired testing at a mean interval of 2.0±0.2 years of Fontan survivors. | n=50, mean 13.7±4.2 years,(F/M 23/27) | No controls | Decreases in RHI (0.002±0.01/yr) were not significant. BMI was a predictor for RHI (R 0.17, p=0.007). | Vascular function does not change uniformly in Fontan survivors. Changes in vascular function do not relate to changes in aerobic capacity but are associated with changes in anthropometric measures and O2 saturation. |
| Vascular function long term after Kawasaki disease: another piece of the puzzle? Pinto et al77 | 2017 | Single-centre prospective study | n=43 Kawasaki patients, age>11 years, diagnosed>5 years ago, with no coronary lesions or any other risk factors for cardiovascular disease. | n=43 control group of individuals without cardiovascular risk factors. | Kawasaki patients had decreased RHI compared with controls (1.59±0.45 vs 1.98±0.41; p<0.001). | Children with Kawasaki disease may have long-term sequelae, even when there is no detectable coronary artery involvement in the acute stage of disease. |
| Endothelial function in children with a history of Henoch Schonlein purpura (HSP). Butbul Aviel et al41 | 2017 | Observational prospective study | n=19 with HSP, 13.5±3.9 years,(F/M 8/11) | n=23 healthy children, 12.8±4.5 years,(F/M 7/16) | Mean RHI 1.81 study group and 1.87 control group (p = 0.18). RHI higher in patients who had endothelial function measured >6 years since HSP diagnosis compared with <6 years (1.98 + 0.74 vs 1.38 ± 0.43 p = 0.037). | This study suggests that HSP causes short-term endothelial dysfunction that improves with time. |
| Reactive hyperaemia index and detection of endothelial dysfunction in children with familial hypercholesterolaemia (FH). Jehlicka et al40 | 2015 | Conference abstract | n=24 with FH, 13.9±2 years. Biochemical markers of endothelial function were assessed. | n=17 healthy controls, 15.2±2.2 years | Significantly lower RHI in FH group (1.63±0.50 and 2.03±0.54; p<0.05). Lower RHI and elevated E-selectin in children with FH. | Possible relationship of ED in children with FH, highlighting the importance of early detection of ED when the atherosclerotic process is still reversible. |
ABPM, ambulatory blood pressure monitoring; BP, systolic blood pressure; FH, familial hypercholesterolaemia; HSP, Henoch Schonlein purpura; peak VO, peak O2 consumption; QOL, quality of life; RHI, reactive hyperemia index; SLE, systemic lupus erythematosus; WC, waist circumference.