Noninvasive cardiac imaging: implications for risk assessment in adolescents and young adults.

Noninvasive imaging of cardiovascular end organ injury has now been applied to adolescents and young adults to better understand the early natural history of chronic heart disease. Echocardiography, assessment of endothelial function, and subclinical atherosclerosis imaging using carotid intima-media thickness measures and coronary calcium identified on computed tomography scanning have all been applied at young ages to demonstrate adverse effects of cardiovascular risk factors. Intervention trials using these techniques as end points may improve understanding of the natural history of acquired cardiovascular disease.