actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.12737/article_59e85cdc033e93.89915718actabiomedica-441Research ArticleПЕДИАТРИЯPEDIATRICSЖёсткость артериальных сосудов: основные детерминанты, методы оценки и связь с ожирением у детей (обзор литературы)Arterial stiffness: basic determinants, methods of assessment, and the connection with obesity in children (literature review)ДанилюкЛ. В.DanilyukL. V.danilyuk-ofd@yandex.ruПогодинаА. В.PogodinaA. V.clinica_zam@inbox.ruРычковаЛ. В.RychkovaL. V.noemail@neicon.ruФГБНУ «Научный центр проблем здоровья семьи и репродукции человека»Scientific Centre for Family Health and Human Reproduction Problems20172809201725(1)106110Copyright © Данилюк Л.В., Погодина А.В., Рычкова Л.В., 20172017Данилюк Л.В., Погодина А.В., Рычкова Л.В.Danilyuk L.V., Pogodina A.V., Rychkova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/441

Обзор литературы освещает особенности структуры и функции артериальных сосудов. Описана демпфирующая функция аорты и формирование прямых и отражённых пульсовых волн. Дано объяснение различному уровню артериального давления (АД) в аорте и периферических артериях. Описаны изменения упруго-эластических свойств артериальных сосудов, которые могут привести к нарушению гемодинамики. Представлены факторы, модифицирующие пульсовую волну: амплификация, аугментация. Отображены основные методы измерения артериальной жёсткости на локальном, регионарном и системном уровнях. Дано представление о современных неинвазивных методах определения эластических свойств артерий. Отмечено преимущество прямого измерения параметров, связанных с жёсткостью артериальной стенки, методом оценки локальной и региональной жёсткости артерий. Отдельно отмечен метод определения скорости распространения пульсовой волны (СРПВ) на каротидно-феморальном участке (кфСРПВ). Данный количественный метод является «золотым стандартом». Представлены данные о влиянии возраста на структуру и функции артерий. Показана необходимость исследования параметров, характеризующих артериальную ригидность у детей с ожирением, так как это заболевание повышает частоту сердечнососудистых осложнений как у взрослых, так и у детей. Рассмотрена связь артериальной сосудистой жёсткости и ожирения в детском возрасте. Приведены различные результаты исследований жёсткости артерий у детей с ожирением. В настоящее время нет единого мнения о применении метода исследования ригидности артериальных сосудов в детском возрасте, что свидетельствует о необходимости дальнейшего изучения сосудистого ремоделирования и факторов, которые могут повлиять на структуру артерий у детей с ожирением.

The review reflects the features of the structure and function of the arteries. The physiological mechanism of the formation of the pulse wave is described, and various levels of arterial pressure in the aorta and peripheral arteries are explained. Disorders of hemodynamics with a change in resilient-elastic properties of arterial vessels are described. Amplification and augmentation - factors modifying the pulse wave are presented. Also the paper describes the main methods of measuring arterial stiffness at the local, regional and system level, the advantage of direct measurement of the parameters related to the stiffness of the arterial wall, and the method of assessing the local and regional rigidity of the arteries. Separately, a method for determining pulse wave velocity in the carotid-femoral region was presented. Data of age impact on the structure and function of the arteries are presented. As it has been shown it is necessary to study parameters characterizing arterial rigidity in obese children, since this disease increases the incidence of cardiovascular complications in both adults and children. The relationship between the stiffness of arterial vessels and obesity children is considered. Various results of studies of arterial stiffness in children with obesity are presented. The lack of a consensus on the use of method of arterial vessels rigidity studying in childhood patients shows the need for further study of vascular remodeling and factors that may affect the structure of arteries in obese children.

артериальная жёсткостьскорость распространения пульсовой волныожирениедетиarterial stiffnesspulse wave velocityobesitychildrenReferencesБолотова Н.В., Посохова Н.В., Новикова Е.П., Дронова Е.Г., Евсеева Е.А. Состояние сосудистой стенки у детей и подростков с метаболическим синдромом // Проблемы эндокринологии. - 2014. - № 2. - С. 8-12Болотова Н.В., Посохова Н.В., Новикова Е.П., Дронова Е.Г., Евсеева Е.А. Состояние сосудистой стенки у детей и подростков с метаболическим синдромом // Проблемы эндокринологии. - 2014. - № 2. - С. 8-12Загоруйко М.В., Бардымова Т.П., Рычкова Л.В. Ожирение у детей и подростков // Сибирский медицинский журнал (Иркутск). - 2010. - № 6. - С. 16-19Загоруйко М.В., Бардымова Т.П., Рычкова Л.В. Ожирение у детей и подростков // Сибирский медицинский журнал (Иркутск). - 2010. - № 6. - С. 16-19Милягин В.А., Комиссаров В.Б. Современные методы определения жесткости сосудов // Артериальная гипертензия. - 2010. - Т. 16, № 2. - С. 1-10Милягин В.А., Комиссаров В.Б. Современные методы определения жесткости сосудов // Артериальная гипертензия. - 2010. - Т. 16, № 2. - С. 1-10Стародубова А.В., Кисляк О.А., Царева О.Н. Артериальная жесткость и оценка скорости пульсовой волны// Лечебное дело. - 2004. - № 2. - С. 80-86Стародубова А.В., Кисляк О.А., Царева О.Н. Артериальная жесткость и оценка скорости пульсовой волны// Лечебное дело. - 2004. - № 2. - С. 80-86Ahimastos AA, Formosa M, Dart AM, Kingwell BA. (2003). Gender differences in large artery stiffness pre- and post-puberty. J Clin Endocrinol Metab, (88), 5375-5380.Ahimastos AA, Formosa M, Dart AM, Kingwell BA. (2003). Gender differences in large artery stiffness pre- and post-puberty. J Clin Endocrinol Metab, (88), 5375-5380.Alastruey J., Hunt A.A., Weinberg P.D. (2014). Novel wave intensity analysis of arterial pulse wave propagation accounting for peripheral reflections. Int J Numer Method Biomed Eng, 30 (2), 249-279.Alastruey J., Hunt A.A., Weinberg P.D. (2014). Novel wave intensity analysis of arterial pulse wave propagation accounting for peripheral reflections. Int J Numer Method Biomed Eng, 30 (2), 249-279.Asmar R. (2015). Effects of treatment on arterial stiffness and central blood pressure-points to consider. J Clin Hypertens (Greenwich), 17 (2), 105-106.Asmar R. (2015). Effects of treatment on arterial stiffness and central blood pressure-points to consider. J Clin Hypertens (Greenwich), 17 (2), 105-106.Borlotti A., Khir A.W., Rietzschel E.R., De Buyzere M.L., Vermeersch S., Segers P. (2012). Noninvasive determination of local pulse wave velocity and wave intensity: changes with age and gender in the carotid and femoral arteries of healthy human. J Appl Physiol, 113 (5), 727-735.Borlotti A., Khir A.W., Rietzschel E.R., De Buyzere M.L., Vermeersch S., Segers P. (2012). Noninvasive determination of local pulse wave velocity and wave intensity: changes with age and gender in the carotid and femoral arteries of healthy human. J Appl Physiol, 113 (5), 727-735.Butlin M., Qasem A. (2017). Large artery stiffness assessment using SphygmoCor technology. Pulse (Basel), 4 (4), 180-192.Butlin M., Qasem A. (2017). Large artery stiffness assessment using SphygmoCor technology. Pulse (Basel), 4 (4), 180-192.Celik A., Ozçetin M., Yerli Y., Damar I.H., Kadi H., Koç F., Ceyhan K. (2011). Increased aortic pulse wave velocity in obese children. Turk Kardiyol Dern Ars, 39 (7), 557-562.Celik A., Ozçetin M., Yerli Y., Damar I.H., Kadi H., Koç F., Ceyhan K. (2011). Increased aortic pulse wave velocity in obese children. Turk Kardiyol Dern Ars, 39 (7), 557-562.Chalmers L.J., Copeland K.C., Hester C.N., Fields D.A., Gardner A.W. (2011). Paradoxical increase in arterial compliance in obese pubertal children. Angiology, (62), 565-570.Chalmers L.J., Copeland K.C., Hester C.N., Fields D.A., Gardner A.W. (2011). Paradoxical increase in arterial compliance in obese pubertal children. Angiology, (62), 565-570.Charakida M., Jones A., Falaschetti E., Khan T., Finer N., Sattar N., Hingorani A., Lawlor D.A., Smith G.D., Deanfield J.E. (2012). Childhood obesity and vascular phenotypes: a population study. J Am Coll Cardiol, 60 (25), 2643-2650.Charakida M., Jones A., Falaschetti E., Khan T., Finer N., Sattar N., Hingorani A., Lawlor D.A., Smith G.D., Deanfield J.E. (2012). Childhood obesity and vascular phenotypes: a population study. J Am Coll Cardiol, 60 (25), 2643-2650.Cheung Y.F. (2010). Arterial stiffness in the young: assessment, determinants, and implications. Korean Circ J, 40 (4), 153-162.Cheung Y.F. (2010). Arterial stiffness in the young: assessment, determinants, and implications. Korean Circ J, 40 (4), 153-162.Dangardt F., Chen Y., Berggren K., Osika W., Friberg P. (2013). Increased rate of arterial stiffening with obesity in adolescents: a five-year follow-up study. PLoS One, (8), e57454.Dangardt F., Chen Y., Berggren K., Osika W., Friberg P. (2013). Increased rate of arterial stiffening with obesity in adolescents: a five-year follow-up study. PLoS One, (8), e57454.Dangardt F., Osika W., Volkmann R., Gan L.M., Friberg P. (2008). Obese children show increased intimal wall thickness and decreased pulse wave velocity. Clin Physiol Funct Imaging, (28), 287-293.Dangardt F., Osika W., Volkmann R., Gan L.M., Friberg P. (2008). Obese children show increased intimal wall thickness and decreased pulse wave velocity. Clin Physiol Funct Imaging, (28), 287-293.Garci'a-Espinosa V., Curcio S., Castro J.M., Arana M., Giachetto G., Chiesa P., Zôcalo Y., Bia D. (2016). Children and adolescent obesity associates with pressure-dependent and age-related increase in carotid and femoral arteries’ stiffness and not in brachial artery, indicative of nonin-trinsic arterial wall alteration. Int J Vasc Med, 4916246.Garci'a-Espinosa V., Curcio S., Castro J.M., Arana M., Giachetto G., Chiesa P., Zôcalo Y., Bia D. (2016). Children and adolescent obesity associates with pressure-dependent and age-related increase in carotid and femoral arteries’ stiffness and not in brachial artery, indicative of nonin-trinsic arterial wall alteration. Int J Vasc Med, 4916246.Harris K.C., Al Saloos H.A., De Souza A.M., Sanatani S., Hinchliffe M., Potts J.E., Sandor G.G. (2012). Biophysical properties of the aorta and left ventricle and exercise capacity in obese children. Am J Cardiol, 110 (6), 897-901. doi: 10.1016/j.amjcard.2012.05.019.Harris K.C., Al Saloos H.A., De Souza A.M., Sanatani S., Hinchliffe M., Potts J.E., Sandor G.G. (2012). Biophysical properties of the aorta and left ventricle and exercise capacity in obese children. Am J Cardiol, 110 (6), 897-901. doi: 10.1016/j.amjcard.2012.05.019.Hidvégi E.V., Illyés M., Benczür B., Böcskei R.M., Râtgéber L., Lenkey Z., Molnâr F.T., Czirâki A. (2012). Reference values of aortic pulse wave velocity in a large healthy population aged between 3 and 18 years. J Hypertens, 30 (12), 2314-2321.Hidvégi E.V., Illyés M., Benczür B., Böcskei R.M., Râtgéber L., Lenkey Z., Molnâr F.T., Czirâki A. (2012). Reference values of aortic pulse wave velocity in a large healthy population aged between 3 and 18 years. J Hypertens, 30 (12), 2314-2321.Hvidt K.N., Olsen M.H., Holm J.C., Ibsen H. (2014). Obese children and adolescents have elevated nighttime blood pressure independent of insulin resistance and arterial stiffness. Am J Hypertens, 27 (11), 1408-1415.Hvidt K.N., Olsen M.H., Holm J.C., Ibsen H. (2014). Obese children and adolescents have elevated nighttime blood pressure independent of insulin resistance and arterial stiffness. Am J Hypertens, 27 (11), 1408-1415.Laurent S., Cockcroft J., Van Bortel L., Boutouyrie P., Giannattasio C., Hayoz D., Pannier B., Vlachopoulos C., Wilkinson I., Struijker-Boudier H., European Network for Non-invasive Investigation of Large Arteries. (2006). Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J, 27 (21), 2588-2605.Laurent S., Cockcroft J., Van Bortel L., Boutouyrie P., Giannattasio C., Hayoz D., Pannier B., Vlachopoulos C., Wilkinson I., Struijker-Boudier H., European Network for Non-invasive Investigation of Large Arteries. (2006). Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J, 27 (21), 2588-2605.Laurent S., Katsahian S., Fassot C., Tropeano A.I., Gautier I., Laloux B., Boutouyrie P. (2003). Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke, 34 (5), 1203-1206.Laurent S., Katsahian S., Fassot C., Tropeano A.I., Gautier I., Laloux B., Boutouyrie P. (2003). Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke, 34 (5), 1203-1206.Leloup A.J., Van Hove C.E., Heykers A., Schrijvers D.M., De Meyer G.R., Fransen P. (2015). Elastic and muscular arteries differ in structure, basal NO production and voltage-gated Ca(2+)-channels. Front Physiol, (6), 375.Leloup A.J., Van Hove C.E., Heykers A., Schrijvers D.M., De Meyer G.R., Fransen P. (2015). Elastic and muscular arteries differ in structure, basal NO production and voltage-gated Ca(2+)-channels. Front Physiol, (6), 375.Lurbe E., Agabiti-Rosei E., Cruickshank J.K., Dominiczak A., Erdine S., Hirth A., Invitti C., Litwin M., Mancia G., Pall D., Rascher W., Redon J., Schaefer F., Seeman T., Sinha M., Stabouli S., Webb N.J., Wühl E., Zanchetti A. (2016). 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens, 34 (10), 1887-1920.Lurbe E., Agabiti-Rosei E., Cruickshank J.K., Dominiczak A., Erdine S., Hirth A., Invitti C., Litwin M., Mancia G., Pall D., Rascher W., Redon J., Schaefer F., Seeman T., Sinha M., Stabouli S., Webb N.J., Wühl E., Zanchetti A. (2016). 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens, 34 (10), 1887-1920.Lurbe E., Torro I., Garcia-Vicent С., Alvarez J., Fernandez-Fornoso J.A., Redon J. (2012). Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertension, (60), 550-555.Lurbe E., Torro I., Garcia-Vicent С., Alvarez J., Fernandez-Fornoso J.A., Redon J. (2012). Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertension, (60), 550-555.Lydakis C., Stefanaki E., Stefanaki S., Thalassinos E., Kavousanaki M., Lydaki D. (2012). Correlation of blood pressure, obesity, and adherence to the Mediterranean diet with indices of arterial stiffness in children. Eur J Pediatr, 171 (9), 1373-1382.Lydakis C., Stefanaki E., Stefanaki S., Thalassinos E., Kavousanaki M., Lydaki D. (2012). Correlation of blood pressure, obesity, and adherence to the Mediterranean diet with indices of arterial stiffness in children. Eur J Pediatr, 171 (9), 1373-1382.Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A., Böhm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., Galderisi M., Grobbee D.E., Jaarsma T., Kirchhof P., Kjeldsen S.E., Laurent S., Manolis A.J., Nilsson P.M., Ruilope L.M., Schmieder R.E., Sirnes P.A., Sleight P., Viigimaa M., Waeber B., Zannad F., Task Force Members. (2013). 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens, 31 (7), 1281-1357.Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A., Böhm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., Galderisi M., Grobbee D.E., Jaarsma T., Kirchhof P., Kjeldsen S.E., Laurent S., Manolis A.J., Nilsson P.M., Ruilope L.M., Schmieder R.E., Sirnes P.A., Sleight P., Viigimaa M., Waeber B., Zannad F., Task Force Members. (2013). 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens, 31 (7), 1281-1357.Newman D.L., Lallemand R.C. (1978). The effect of age on the distensibility of the abdominal aorta of man. Surg Gynecol Obstet, 147 (2), 211-214.Newman D.L., Lallemand R.C. (1978). The effect of age on the distensibility of the abdominal aorta of man. Surg Gynecol Obstet, 147 (2), 211-214.Nichols W.W., O’Rourke M.F. (2005). McDonald’s blood flow in arteries; theoretical, experimental and clinical principles. Oxford, 624.Nichols W.W., O’Rourke M.F. (2005). McDonald’s blood flow in arteries; theoretical, experimental and clinical principles. Oxford, 624.Pac F.A., Guray Y., Polat T.B. (2010). Wall motion velocities of ascending aorta measured by tissue Doppler imaging in obese children. Pediatr Int, (52), 778-784.Pac F.A., Guray Y., Polat T.B. (2010). Wall motion velocities of ascending aorta measured by tissue Doppler imaging in obese children. Pediatr Int, (52), 778-784.Rossi P., Frances Y., Kingwell B.A., Ahimastos A.A. (2011). Gender differences in artery wall biomechanical properties throughout life. J Hypertens, (29), 1023-1033.Rossi P., Frances Y., Kingwell B.A., Ahimastos A.A. (2011). Gender differences in artery wall biomechanical properties throughout life. J Hypertens, (29), 1023-1033.Safar M.E. (2010). Can antihypertensive treatment reverse large-artery stiffening? Curr Hypertens Rep, 12 (1), 47-51.Safar M.E. (2010). Can antihypertensive treatment reverse large-artery stiffening? Curr Hypertens Rep, 12 (1), 47-51.Stefanadis C., Dernellis J., Tsiamis E., Stratos C., Diamantopoulos L., Michaelides A., Toutouzas P. (2000). Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease. Eur Heart J, 21 (5), 390-396.Stefanadis C., Dernellis J., Tsiamis E., Stratos C., Diamantopoulos L., Michaelides A., Toutouzas P. (2000). Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease. Eur Heart J, 21 (5), 390-396.Tryggestad J.B., Thompson D.M., Copeland K.C., Short K.R. (2012). Obese children have higher arterial elasticity without a difference in endothelial function: the role of body composition. Obesity, (20), 165-171.Tryggestad J.B., Thompson D.M., Copeland K.C., Short K.R. (2012). Obese children have higher arterial elasticity without a difference in endothelial function: the role of body composition. Obesity, (20), 165-171.Urbina E.M., Kimball T.R., Khoury P.R., Daniels S.R., Dolan L.M. (2010). Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus. J Hypertens, 28 (8), 1692-1698.Urbina E.M., Kimball T.R., Khoury P.R., Daniels S.R., Dolan L.M. (2010). Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus. J Hypertens, 28 (8), 1692-1698.Van Bortel L.M., Laurent S., Boutouyrie P., Chowienczyk P., Cruickshank J.K., De Backer T., Filipovsky J., Huybrechts S., Mattace-Raso F.U., Protogerou A.D., Schillaci G., Segers P., Vermeersch S., Weber T., Artery Society, European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. (2012). Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens, 30 (3), 445-448.Van Bortel L.M., Laurent S., Boutouyrie P., Chowienczyk P., Cruickshank J.K., De Backer T., Filipovsky J., Huybrechts S., Mattace-Raso F.U., Protogerou A.D., Schillaci G., Segers P., Vermeersch S., Weber T., Artery Society, European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. (2012). Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens, 30 (3), 445-448.Wu C.F., Liu P.Y., Wu T.J., Hung Y., Yang S.P., Lin G.M. (2015) Therapeutic modification of arterial stiffness: An update and comprehensive review. World J Cardiol, 7 (11), 742-753.Wu C.F., Liu P.Y., Wu T.J., Hung Y., Yang S.P., Lin G.M. (2015) Therapeutic modification of arterial stiffness: An update and comprehensive review. World J Cardiol, 7 (11), 742-753.Zheng J., Ye P., Xiao W.K., Luo L.M., Wu H.M. (2011). Correlations between different obese indexes and arterial stiffness among populations at the community level. Zhonghua Liu Xing Bing Xue Za Zhi, 32 (5), 465-48.Zheng J., Ye P., Xiao W.K., Luo L.M., Wu H.M. (2011). Correlations between different obese indexes and arterial stiffness among populations at the community level. Zhonghua Liu Xing Bing Xue Za Zhi, 32 (5), 465-48.

The authors declare that there are no conflicts of interest present.