Steinmann Markus, Abbas Chiara, Singer Florian, Casaulta Carmen, Regamey Nicolas, Haffner Dieter, Fischer Dagmar-Christiane, Simonetti Giacomo D
Division of Pediatric Nephrology, Department of Pediatrics, Inselspital, Bern University Hospital, and University of Bern, 3010, Bern, Switzerland,
Eur J Pediatr. 2015 Apr;174(4):519-23. doi: 10.1007/s00431-014-2423-2. Epub 2014 Sep 25.
Altered arterial stiffness is a recognized risk factor of poor cardiovascular health. Chronic inflammation may increase arterial stiffness. We tested whether arterial stiffness is increased children with asthma, a chronic disease characterized by fluctuating airway and systemic inflammation. Arterial stiffness, expressed as carotid-femoral pulse wave velocity (PWVcf), was measured in 37 mild-to-moderate asthmatic children: 11 girls, median (range) age 11.1 years (6-15). PWVcf in asthma was compared to PWVcf in 65 healthy controls matched for age, height, and gender previously studied in Germany and was correlated with airway inflammation and obstruction. PWVcf was higher in asthmatic children compared to controls: PWVcf median (interquartile range) was 4.7 m/s (4.5-4.9) vs. 4.3 m/s (4.1-4.7), p < 0.0001. In asthmatic children, PWVcf was inversely associated (r (2) = 0.20, p = 0.004) with forced expiratory volume in 1 s (FEV1). This association remained significant after adjusting for possible confounders including body mass index, blood pressure, steroid use, and FeNO.
Arterial stiffness is increased in children with mild-to-moderate asthma. The association between impaired lung function and increased arterial stiffness suggests that severity of disease translates into detrimental effects on the cardiovascular system.
动脉僵硬度改变是公认的心血管健康不良风险因素。慢性炎症可能会增加动脉僵硬度。我们测试了哮喘患儿(一种以气道和全身炎症波动为特征的慢性疾病)的动脉僵硬度是否增加。对37名轻度至中度哮喘患儿(11名女孩,年龄中位数[范围]为11.1岁[6 - 15岁])测量了以颈股脉搏波速度(PWVcf)表示的动脉僵硬度。将哮喘患儿的PWVcf与先前在德国研究的65名年龄、身高和性别相匹配的健康对照者的PWVcf进行比较,并与气道炎症和阻塞相关联。与对照组相比,哮喘患儿的PWVcf更高:PWVcf中位数(四分位间距)为4.7米/秒(4.5 - 4.9),而对照组为4.3米/秒(4.1 - 4.7),p < 0.0001。在哮喘患儿中,PWVcf与第1秒用力呼气量(FEV1)呈负相关(r² = 0.20,p = 0.004)。在调整了包括体重指数、血压、类固醇使用和呼出气一氧化氮(FeNO)等可能的混杂因素后,这种关联仍然显著。
轻度至中度哮喘患儿的动脉僵硬度增加。肺功能受损与动脉僵硬度增加之间的关联表明疾病严重程度会转化为对心血管系统的有害影响。