Evaluation of autonomic modulation of lung function and heart rate in children with cystic fibrosis

Carvalho, Etiene Farah Teixeira de; Aletti, Federico; Costa, Ivan Peres; Gomes, Évelim Leal de Freitas Dantas; Silva, Natália Pereira da; Damasceno, Neiva; Muramatu, Lucia Harumi; Alves, Vera Lúcia dos Santos; Ferrario, Manuela; Cahalin, Lawrence P.; Sampaio, Luciana Maria Malosá

doi:10.1002/ppul.25147

Cited by 2 publications

(1 citation statement)

References 42 publications

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“…The higher heart rate of adolescents with CF is in line with previous studies, and has been attributed to the cardiovascular effects of their lung disease, and to autonomic dysfunction. 31 , 32 Their higher heart rate could affect arterial stiffness, even though adolescents with CF showed a normal diastolic and systolic blood pressure. Moreover, aortic lumen area was identified as a predictor for AWT.…”

Section: Discussionmentioning

confidence: 99%

Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease

Ververs

Eikendal

Kofink

et al. 2022

JAHA

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Background Adolescents with chronic disease are often exposed to inflammatory, metabolic, and hemodynamic risk factors for early atherosclerosis. Since postmortem studies have shown that atherogenesis starts in the aorta, the CDACD (Cardiovascular Disease in Adolescents with Chronic Disease) study investigated preclinical aortic atherosclerosis in these adolescents. Methods and Results The cross‐sectional CDACD study enrolled 114 adolescents 12 to 18 years old with chronic disorders including juvenile idiopathic arthritis, cystic fibrosis, obesity, corrected coarctation of the aorta, and healthy controls with a corrected atrial septal defect. Cardiovascular magnetic resonance was used to assess aortic pulse wave velocity and aortic wall thickness, as established aortic measures of preclinical atherosclerosis. Cardiovascular magnetic resonance showed a higher aortic pulse wave velocity, which reflects aortic stiffness, and higher aortic wall thickness in all adolescent chronic disease groups, compared with controls ( P <0.05). Age (β=0.253), heart rate (β=0.236), systolic blood pressure (β=−0.264), and diastolic blood pressure (β=0.365) were identified as significant predictors for aortic pulse wave velocity, using multivariable linear regression analysis. Aortic wall thickness was predicted by body mass index (β=0.248) and fasting glucose (β=0.242), next to aortic lumen area (β=0.340). Carotid intima‐media thickness was assessed using ultrasonography, and was only higher in adolescents with coarctation of the aorta, compared with controls ( P <0.001). Conclusions Adolescents with chronic disease showed enhanced aortic stiffness and wall thickness compared with controls. The enhanced aortic pulse wave velocity and aortic wall thickness in adolescents with chronic disease could indicate accelerated atherogenesis. Our findings underscore the importance of the aorta for assessment of early atherosclerosis, and the need for tailored cardiovascular follow‐up of children with chronic disease.

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Section: Discussionmentioning

confidence: 99%

Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease

Ververs

Eikendal

Kofink

et al. 2022

JAHA

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

Pessoa,

Velloso,

Inácio

et al. 2024

Sci Rep

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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.

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Evaluation of autonomic modulation of lung function and heart rate in children with cystic fibrosis

Cited by 2 publications

References 42 publications

Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease

Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease

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

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