Noninvasive Methods to Assess Vascular Health in Children and Adolescents: Current State-of-the-Art and Future Perspectives.

Vascular remodeling, which occurs with normal aging and several pathological states, has emerged as a critical factor in assessing cardiovascular health in children. Changes in vascular structure, stiffness, and function have been shown to be associated with different diseases in children and adolescents, including metabolic syndrome, congenital heart disease, and childhood cancer. However, there is a lack of data on the ability of these vascular parameters to predict outcomes and guide therapy in the pediatric population. This paper provides an overview of the physiological principles related to pediatric vascular health and the available noninvasive methods for the measurement of arterial structure, stiffness, and function. The normal variation of these parameters during childhood and their clinical relevance in pathological conditions are discussed, with an emphasis on current knowledge gaps and the need for future research.