• cardiovascular risk
• childhood obesity
• endothelial dysfunction
• oxidative stress
• vascular inflammation

The functional integrity of the endothelium is a fundamental element of vascular health. Chronic exposure to cardiovascular risk factors and oxidative stress overwhelms the defense mechanisms of the vascular endothelium, which is followed by endothelial dysfunction and the loss of the endothelium’s integrity. Endothelial dysfunction has been detected in the coronary epicardial and resistance vasculature and in peripheral arteries, so it can be regarded as a systemic condition. Besides classical cardiovascular risk factors (diabetes, smoking, hypertension, dyslipidemia, obesity, aging) related to oxidative stress, we will analyse other mechanisms of endothelial dysfunction sush as inflammation, focusing on C-reactive protein levels and autoimmune inflammatory diseases; specific viral and bacterial infections; vitamin D deficiency. The central topic will be the childhood origins of endothelial dysfunction and correlation, following the life line of the little patient, with fetal well being, bird wight, early postnatal nutrition, mild childhood respiratory infections, chilhood obesity and its different features from adulte obesity. The centrality of this topic is due to the fact that there are many studies correlating endothelial dysfunction (conduit artery and microvasculature likewise) with cardiovascular risk and the effects of cardiovascular risk on the endothelium can be seen in children as early as 8 years of age. During the surgical manegement of the pediatric patient,information about relevant medical history, integrated with data from the study of microcirculation, can provide a more comprehensive evaluation of the patient, which can be studied and analyzed.