Eur J Pediatr . Investigation of endothelial dysfunction and arterial stiffness in multisystem inflammatory syndrome in children

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Eur J Pediatr


. 2021 Jul 2;1-7.
doi: 10.1007/s00431-021-04136-6. Online ahead of print.
Investigation of endothelial dysfunction and arterial stiffness in multisystem inflammatory syndrome in children


Murat Çiftel ¹ , Nurgül Ateş ² , Osman Yılmaz ³



Affiliations

• PMID: 34212240
• PMCID: PMC8249181
• DOI: 10.1007/s00431-021-04136-6

Abstract

Severe acute respiratory syndrome coronavirus 2 infection can result in multisystem inflammatory syndrome in children (MIS-C). MIS-C can lead to myocardial dysfunction, heart failure, and multiorgan failure; the primary finding is hyperinflammation. Endothelial dysfunction has not been evaluated in patients with MIS-C. We investigated endothelial dysfunction and arterial stiffness parameters in patients with MIS-C. The study included 38 pediatric patients (20 males and 18 females aged 4-17 years, mean age 8.89 years) with MIS-C. Thirty-eight age- and sex-matched healthy individuals were enrolled as the control group. Systolic and diastolic ventricular measurements and systolic and diastolic measurements of ascending aorta diameter were performed by M-mode echocardiography. Endothelial dysfunction was evaluated using flow-mediated dilation by measuring the brachial artery diameter with a high-resolution probe. The MIS-C group had lower flow-mediated dilation than did the controls. The MIS-C group had decreased aortic strain and aortic distensibility values and correlations between decreased flow-mediated dilation and reduced aortic strain, aortic distensibility, and reduced ejection fraction.Conclusion: The results show that patients with MIS-C had endothelial dysfunction and arterial stiffness. Furthermore, the degree of endothelial dysfunction correlated with reduced ejection fractions.What is Known:•Endothelial dysfunction and arterial stiffness are unknown in patients with MIS-C.•The effect of endothelial dysfunction and arterial stiffness on decreased cardiac function is unknown.What is New:•MIS-C patients have endothelial dysfunction and arterial stiffness.•There is a link between left ventricular dysfunction and reduced endothelial dysfunction in patients with MIS-C.

Keywords: Arterial stiffness; Endothelial dysfunction; Flow-mediated dilation; Multisystem inflammatory syndrome in children.