About this trial
Children living with chronic health conditions face a higher risk of developing cardiovascular diseases than their peers, largely due to the accelerated aging of the heart and blood vessels. Although experts recognize this elevated risk and recommend close monitoring and early intervention, the underlying mechanisms driving this phenomenon remain poorly understood. At present, no effective interventions specifically target its root causes.
Recent research shows that both large blood vessels (such as the carotid artery) and small vessels (such as those in the retina) can display early signs of damage decades before clinically apparent heart or vascular disease emerges. This accelerated vascular aging can result from multiple factors - including disease-related processes such as persistent inflammation and metabolic disturbances, treatment-related effects such as chemotherapy or long-term steroid use, and lifestyle changes associated with chronic illness, such as reduced physical activity and altered eating habits. However, it is still unclear how these factors influence the development and progression of vascular changes in children as they grow. Importantly, these changes can be monitored through non-invasive methods, offering a unique opportunity to study at-risk patients many years before overt cardiovascular disease develops.
Identifying these early changes may enable us to detect and track individuals at heightened risk well in advance of clinical disease. This study aims to deepen our understanding of the causes of increased cardiovascular risk in children with chronic conditions and to lay the groundwork for earlier, more targeted prevention strategies.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Individuals aged between 6 and 25 years;
Diagnosed with a chronic childhood condition/disease associated with an increased risk of early cardiovascular disease;
Provided informed consent (if over 18 years old) or had informed consent provided by their legal guardian (if under 18 years old) following appropriate information about the study.
Disqualifiers
Severe intellectual and developmental disability;
Decompensated heart failure;
Severe primary immunodeficiency;
Ongoing intravenous chemotherapy;
Trial population
Children, adolescents, and young adults (aged 6-25 years) who have been diagnosed with a chronic childhood condition associated with an increased risk of early-onset cardiovascular disease, and who are receiving care at a university-affiliated clinical setting. Participants must be capable of providing informed consent (if ≥18 years old) or have consent provided by a legal guardian (if \<18 years old). The population excludes individuals with severe intellectual disabilities, decompensated heart failure, severe primary immunodeficiencies, active intravenous chemotherapy, communicable diseases that pose a public health risk, or a history of regular alcohol or drug use.
Trial design
Cohort
Prospective
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
Arterial stiffness
Assessed by carotid-femoral pulse wave velocity
Endothelial function of the brachial artery
Evaluated using flow-mediated dilation measured by ultrasound
Retinal vessel diameter
Assessed by static retinal vessel analysis
Retinal vessel fractal dimension and tortuosity
Assessed by static retinal vessel analysis
Secondary outcomes
Endothelial function in capillaries
Assessed by flow-mediated dilation using laser speckle contrast imaging
Retinal neurovascular coupling
Assessed by dynamic retinal vessel analysis
Sponsors and contacts
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