Résumé
In young adults, a family history of premature coronary artery disease [CAD], as well as genetic and environmental factors are independent risk factors for coronary artery disease. Endothelial function was studied in 30 children [21 boys and 9 girls with mean age of 14.9 +/- 2.3 years old]of patients with documented CAD [men .45 and women .50 years old]. Chidren did not have any history of diabetes mellitus, dyslipidemia, hypertension, and smoking [active/passive]. Using vascular ultrasound, we measured resting Basal Brachial artery Diameter [BBD] and Endothelium-Dependent Dilatation [EDD] in response to increased flow and sublingual glyceryltrinitrate [GTN], an Endothelium-Independent Dilation [EID]. These parameters were also measured in 30 control subjects with normal parents [18 boys and 12 girls with mean age of 14.2 +/- 2/5years old] and results were compared with each other. Adolescents in CAD group had abnormal Endothelial Dependent Dilatation or EDD/BBD [8.5 +/- 3.4% vs 11.8 +/- 4.5% in control subjects; P= 0.003].Endothelial Independent Dilatation [EID/BBD] in the positive fimily history group was significantly more than control subjects [18.5 +/- 6.7% vs 11.9 +/- 5.2%; P <0.001]. EDD/EID or the index of endothelial function was significantly lower in the positive family history group [0.92 +/- 0.05 vs 1 +/- 0.03; P<0.001]. There was no difference in EDD/EID index between those with history of premature CAD in mother [7 cases] and those with history of premature CAD in father [23 cases] [0.92 +/- 0.04 vs 0.91 +/- 0.05]. Normal adolescents without any cardiovascular risk factors but a history of premature coronary artery disease in one parent may have endothelial dysfunction, and there is no difference whether the CAD is in mother or father