Cardiovascular disease in the young
Our focus is to study cardiovascular diseases presenting in the young as well as early cardiovascular disease progression of diseases commonly observed in adult life. This includes prospective studies using novel technologies for the assessment of the development of the cardiovascular system extending from early childhood to adolescence and young adulthood and how this is influenced by the fetal stage, different diseases, treatments, and cardiovascular risk factors.
The development of clinical atherosclerosis commonly observed in adult life is a multifactorial life-time process with its origins in the pediatric age. This process is influenced not only by heredity, but also by disease and cardiovascular risk factors from early childhood or even as early as the fetal stage. The impact of disease, treatments, and cardiovascular risk factors on the evolution in vascular form and function in children with congenital and acquired diseases is still unclear. This is partly related with shortcomings in methodology developed primarily for adults with more advanced disease progression,
We study the evolution of the cardiovascular structure using a novel non-invasive method based on ultra-high frequency ultrasound (UHF, frequency 22-70 MHz) and arterial function in different childhood diseases and family populations spanning from the prenatal age to young adulthood, and with an emphasis on transgenerational transformation of cardiovascular risk, to elucidate the long-term impact of disease and cardiovascular risk for development of clinical atherosclerosis.
Major collaboration projects (RADIEL-study, SIVELU-study, and FINNCARE-study NCT04676295) include the prospectively recruitment and assessment of families at risk for developing cardiovascular disease long-term with a focus on the assessment of cardiovascular risk profiles (body composition, blood pressure, diet, physical activity, lipids, glucose, and inflammation) in combination with cardiovascular phenotyping. We are also looking into innovative ways of improving oral health through intensified counselling provided during the first yearly years of life to families with children with major congenital heart disease at risk for endocarditis long-term in the ORALPEDHEART-study (trial registration NCT03329170).
Selected publications
Renlund M, Jääskeläinen TJ, Kivelä A, Heinonen S, Laivuori H, Sarkola T. Blood pressure, arterial stiffness, and cardiovascular risk profiles in 8-12-year-old children following pre-eclampsia (FINNCARE-study). J Hypertens. 2023 Sep 1;41(9):1429-1437. doi: 10.1097/HJH.0000000000003485
Renlund M, Jääskeläinen TJ, Kivelä A, Heinonen S, Laivuori H, Sarkola T. Determinants of vascular structure and function in at-risk children born to mothers managed for pre-eclampsia (FINNCARE study). Front Cardiovasc Med. 2023 Oct 4;10:1264921. doi: 10.3389/fcvm.2023.1264921.
Pulkkinen MA, Tuomaala AK, Hero M, Gordin D, Sarkola T. Motivational Interview to Improve Vascular Health in Adolescents with Poorly Controlled Type 1 Diabetes (MIAD): A Randomized Controlled Trial. BMJ Open Diabetes Res Care 2020 Jul;8(1):e001216. doi: 10.1136/bmjdrc-2020-001216.
Sundholm J, Suominen A, Sarkola T, Jahnukainen K. Early arterial intimal thickening and plaque is related with treatment regime and cardiovascular risk factors in young adults following childhood hematopoietic stem cell transplantation. J Clin Med. 2020 Jul 13;9(7):2208. doi: 10.3390/jcm9072208.
Ylinen M, Tyni V, Pihkala JI, Salminen J, Sairanen H, Sarkola T. Procedural riskfactors, incidence, and timing of reintervention after treatment for native coarctation of aorta in children – a population based study. Eur J Cardiothorac Surg 2019 Mar 1;55(3):564-571. doi: 10.1093/ejcts/ezy252. doi: 10.1093/ejcts/ezy252.
Sundholm JKM, Litwin L, Rönö K, Koivusalo S, Eriksson JG, Sarkola T. Maternal obesity and gestational diabetes: impact on early childhood arterial wall layer thickness and stiffness – RADIEL six years follow-up. Atherosclerosis 2019;284:237-244. doi: 10.1016/j.atherosclerosis.2019.01.037.
Sarkola T, Manlhiot C, Slorach C, Bradley TJ, Hui W, Mertens L, Redington AN, Jaeggi E. Evolution of the Arterial Structure and Function from Infancy to Adolescence is related to Anthropometric and Blood Pressure Changes. Arterioscler Thromb Vasc Biol. 2012;32:2516-24. doi: 10.1161/ATVBAHA.112.252114.
Olander R, Sundholm JKM, Ojala TH, Andersson S, Sarkola T. Neonatal arterial morphology is related to body size in abnormal human fetal growth. Circulation: Cardiovascular Imaging 2016 Sep;9(9). pii: e004657. doi: 10.1161/CIRCIMAGING.116.004657.
Sundholm JKM, Paetau A, Albäck A, Pettersson T, Sarkola T. Non-invasive vascular very-high resolution ultrasound to quantify artery intima layer thickness: validation of the four-line pattern. Ultrasound Med Biol. 2019 Aug;45(8):2010-2018. doi: 10.1016/j.ultrasmedbio.2019.04.017
Sarkola T, Redington A, Keeley F, Bradley T, Jaeggi E. Transcutaneous very-high-resolution ultrasound to quantify arterial wall layers of muscular and elastic arteries: Validation of a method. Atherosclerosis. 2010;212:516-23. doi: 10.1016/j.atherosclerosis.2010.06.043.
External funding
Finnish Foundation for Pediatric Research
Medical Society of Finland
Medicinska understödsföreningen Liv och Hälsa r.f.
Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perkléns minne