This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The pediatric syndrome of sleep disordered breathing encompasses children with simple snoring, obstructive hypoventilation and varying degrees of obstructive sleep apnea. The syndrome occurs in more than 12% of children, with most having mild to moderate involvement. Without knowledge of the long-term cardiovascular morbidity with less severe forms of SDB, adequate management of children with the disorder and prevention of cardiovascular disease during adulthood cannot be assessed. We hypothesize that in children with SDB, increased systemic levels of inflammatory cytokines and acute phase reactants correlate with severity of the disorder and with vascular and myocardial remodeling. We have reported left ventricular changes in children with SDB occurring independently of hypertension and obesity. The mechanism of left ventricular remodeling remains undefined. Our data show that in children with SDB there is a strong association between plasma levels of acute phase reactants and left ventricular mass. Similarly, levels of plasma cytokines correlate with carotid artery intima thickness.The goals of this study are threefold: 1) to compare inflammatory cardiovascular disease mechanisms in 5- to 13-year-old children with varying degrees of SDB to those in normal controls; 2) to determine how cytokine levels in plasma relate to those in tonsils; 3) to examine the relationship between inflammatory markers and carotid intima thickness, carotid compliance, pulse pressure, aortic stiffness and left ventricular mass and function before and after adenotonsillectomy.
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