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成人囊性纤维化患者亚临床血管、血流动力学和动脉僵硬度变化:横断面观察性研究。

Subclinical vascular, hemodynamic and arterial stiffness changes in adults with cystic fibrosis: cross-sectional observational study.

机构信息

Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais, Alameda Ezequiel Dias, 275-Centro, Belo Horizonte, MG, 30130-110, Brazil.

Adult Cystic Fibrosis Center, Júlia Kubitschek Hospital-FHEMIG, Rua Dr. Cristiano Rezende, 2745-Milionários, Belo Horizonte, MG, 30610-720, Brazil.

出版信息

Sci Rep. 2024 Jun 7;14(1):13178. doi: 10.1038/s41598-024-63904-0.

Abstract

Cardiovascular diseases can be an emerging complication in cystic fibrosis (CF), as the median life expectancy has improved considerably. The objective of this study was to compare vascular, hemodynamic parameters and arterial stiffness in adult CF patients with healthy participants pared by sex and age, and to assess the factors associated with arterial stiffness in the CF group. This is a cross-sectional observational study. The evaluation of cardiovascular parameters was performed non-invasively using Mobil-O-Graph. 36 individuals with CF and 35 controls were evaluated. The mean arterial pressure (96.71 ± 10.98 versus 88.61 ± 7.40 mmHg, p = 0.0005), cardiac output (4.86 ± 0.57 versus 4.48 ± 0.44 L/min, p = 0.002) and systolic volume (64.30 ± 11.91 versus 49.02 ± 9.31 ml, p < 0.0001) were significantly lower in the CF group. The heart rate was higher in the CF when compared to the control (77.18 ± 10.47 versus 93.56 ± 14.57 bpm, p < 0.0001). The augmentation index (AIx@75) was higher in the CF than control (29.94 ± 9.37 versus 16.52 ± 7.179%, p < 0.0001). In the multivariate model controlled by body mass index and Forced Expiratory Volume in the first second, central systolic blood pressure and reflection coefficient directly related to AIx@75. Negatively related to AIx@75 were age and systolic volume. The adjusted determination coefficient was 87.40%. Individuals with CF presented lower arterial blood pressures and changes in cardiac function with lower stroke volume and cardiac output. The AIx@75, an indirect index of arterial stiffness and direct index of left ventricular overload, is increased in this population. The subclinical findings suggest the need for earlier cardiovascular assessment in this population due to increased risks of cardiovascular disease.

摘要

心血管疾病可能是囊性纤维化 (CF) 的一种新出现的并发症,因为其平均预期寿命已经大大提高。本研究的目的是比较成年 CF 患者与健康对照者的血管、血流动力学参数和动脉僵硬度,并评估 CF 组中与动脉僵硬度相关的因素。这是一项横断面观察性研究。使用 Mobil-O-Graph 进行了心血管参数的非侵入性评估。共评估了 36 名 CF 患者和 35 名对照者。CF 组的平均动脉压(96.71 ± 10.98 对 88.61 ± 7.40 mmHg,p = 0.0005)、心输出量(4.86 ± 0.57 对 4.48 ± 0.44 L/min,p = 0.002)和收缩量(64.30 ± 11.91 对 49.02 ± 9.31 ml,p < 0.0001)显著降低。与对照组相比,CF 组的心率更高(77.18 ± 10.47 对 93.56 ± 14.57 bpm,p < 0.0001)。CF 组的增强指数(AIx@75)高于对照组(29.94 ± 9.37 对 16.52 ± 7.179%,p < 0.0001)。在通过体重指数和第一秒用力呼气量控制的多元模型中,中心收缩压和反射系数与 AIx@75 直接相关。与 AIx@75 呈负相关的是年龄和收缩量。调整后的确定系数为 87.40%。CF 患者的动脉血压较低,心脏功能发生变化,表现为每搏输出量和心输出量较低。AIx@75 是动脉僵硬度的间接指标,也是左心室负荷过重的直接指标,在该人群中增加。这些亚临床发现表明,由于心血管疾病风险增加,需要对该人群进行更早的心血管评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a0/11161579/c00c030d1274/41598_2024_63904_Fig1_HTML.jpg

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