Matters of the Heart: Clinical trials study effects of heart disease

Matters of the Heart: Clinical trials study effects of heart disease
Are kids with heart disease at risk for premature aging of the arteries? 

Clinical research at Children’s Hospital is uncovering the answer to this and other questions about the long-term effects of heart disease in children. In conjunction with The Clinical Trials Center, the study, led by Children’s Hospital cardiologist and LSUHSC Professor of Clinical Pediatrics Christian Lilje, MD, sought early evidence of premature arterial aging in patients with diabetes, congenital heart disease and healthy controls. The study was part of a collaborative investigation into cardiovascular dysfunction in children with diabetes with the division of endocrinology led by Children’s Hospital endocrinologist and LSUSC Professor of Pediatrics Stuart Chalew, MD.

The first phase of the study determined the best artery to evaluate by measuring the intima-media thickness, or inner lining, of several arteries in the study’s 185 participants.

“We know patients with diabetes experience premature aging of their arteries, and their intima-media thickness should be abnormal,” said Dr. Lilje. “This study with diabetes patients showed that the aorta is a better artery to measure in children than the conventional carotid artery.”

The team studied key early events in the aging of different arteries. Arterial aging seems to begin in the aorta, the largest artery. Measuring the aortic intima-media thickness in the diabetic population provided a sensitive tool to find abnormalities in children.

“We found similar results when we looked at our heart patients,” said Dr. Lilje, who examined 22 patients with noncomplex heart issues many years after surgery. The patients, ages 8 to 18, although asymptomatic, showed increased thickness of the intima-media in the aorta. “Now we know these patients need to be followed more closely or monitored for standard risk factors that lead to aging of the arteries, such as high blood pressure, overweight, too little exercise, tobacco exposure, diabetes, high lipids, etc.”

Dr. Lilje’s work has been presented at several national and international meetings. His next step is to design a study to evaluate these patients years later for progression of arterial damage and possible interventional strategies to prevent progression of complications. He also hopes to study the impact that timing and duration of heart surgeries might have on arteries.

“Once we know these children’s hearts are fixed and they’re doing well, we want to make sure their arteries are also fine.”

Learn more about the Clinical Trials at Children's Hospital by visiting www.chnola.org/ClinicalTrials