Neinvazivní hodnocení endoteliální dysfunkce u dětí s rizikem předčasné manifestace aterosklerózy

• Main Author: Jehlička, Petr
• Other Authors: Piťha, Jan
• Format: Doctoral Thesis
• Language: Czech
• Published: 2009
• Online Access: http://www.nusl.cz/ntk/nusl-273452

MUDr. JEHLIČKA SUMMARY This study has focused on a new method for the assessment of endothelial dysfunction (ED) using the Deceleration Index (DI). A total of 242 ultrasonographic examinations were performed in 92 children (FH 32, DM1 30, healthy controls 3O). The average DI values were 21.8%(±9.4)in healthy children, 19.9%(±9)in FH and 17.6%(±14)in the DM1 group. There were statistically insignificant differences between the study groups. This was most probably due to the high biological variability of the method employed. The coefficient of variation of DI was 1.02 (0.68 -1.53). Therefore, the clinical usefulness of DI is limited with regards to the individual assessment of ED and thus for the prediction of cardiovascular risk. The association of ADMA and oxLDL with ED and their superior sensitivity compared to DI and FMD has been confirmed in our study. Folic acid supplementation did not lead to a statistically signifiant improvement of DI and FMD. Similarly, plasma levels of ADMA and oxLDL remained unchanged despite a decrease of homocysteine and hsCRP in these children. This finding demonstrates a complicated relationship between ADMA, homocysteine and folic acid. The protective effect of folic acid on ED in high risk children was not confirmed in this study.