İdiyopatik pulmoner fibrozisli hastalarda nabız dalga hızı, intima media kalınlığı ve akım aracılı dilatasyon ile kardiyovasküler risk değerlendirmesi
Abstract
Amaç: Koroner arter hastalığına yatkınlık oluşturan fibrotik akciğer hastalıklarının altında yatan mekanizma henüz netlik kazanmamıştır. Kronik inflamasyon ateroskleroza katkıda bulunabilir ve kardiyovasküler riskin artmasında rol oynayabilir. Bu çalışmada, idiyopatik pulmoner fibrozlu (IPF) hastalarda karotis-femoral nabız dalga hızı (PWV), karotis intima media kalınlığı (CIMT) ve akım aracılı dilatasyon (FMD) ölçerek subklinik aterosklerozu araştırmayı amaçladık.
Metod: Bu kesitsel çalışma, Eylül 2019 ile Eylül 2021 tarihleri arasında yeni tanı almış 55 IPF hastası ve 55 sağlıklı kontrolden oluştu. Kardiyovasküler Risk Değerlendirmesi, FMD ile ölçülen endotelyal fonksiyon, karotis doppler ultrasonografi ile ölçülen CIMT ve PWV ile ölçülen arteriyel sertlik ile değerlendirildi.
Bulgular: Çok değişkenli regresyon modellerinde, IPF'nin varlığı CIMT (β ± SE = 0.18 ± 0.05, p = 0.002), log(FMD) (β ± SE = –0.15 ± 0.04, p < 0.001) ve log(PWD) (β ± SE = 0.16 ± 0.03, p < 0.001) için ortak bağımsız prediktör olarak saptandı. Artan log(PWV) seviyeleri, artan CIMT ve log(FMD) için ortak bağımsız öngörücüler idi. CRP seviyeleri ile CIMT (r = 0.359, p = 0.009) ve PWV (r = 0.338, p = 0.018) seviyeleri arasında pozitif korelasyon saptandı, FMD seviyeleri ile negatif korelasyon belirlendi (r = -0.372, p = 0.004).
Sonuç: IPF hastalarında endotel disfonksiyonu ve ateroskleroz riski yüksektir. Sürekli bir inflamatuar yanıt, ateroskleroz sürecinde önemli bir rol oynamış olabilir.
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References
- Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of idiopathic pulmonary fibrosis. an official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 198: e44-e68.
- Agrawal A, Verma I, Shah V, Agarwal A, Sikachi RR. Cardiac manifestations of idiopathic pulmonary fibrosis. Intractable Rare Dis Res 2016; 5: 70-5.
- Dalleywater W, Powell HA, Hubbard RB, Navaratnam V. Risk factors for cardiovascular disease in people with idiopathic pulmonary fibrosis: a population-based study. Chest 2015; 147: 150-6.
- Kreuter M, Ehlers-Tenenbaum S, Palmowski K, et al. Impact of comorbidities on mortality in patients with idiopathic pulmonary fibrosis. PLoS One 2016; 11: e0151425.
- Summerhill VI, Grechko AV, Yet SF, Sobenin IA, Orekhov AN. The atherogenic role of circulating modified lipids in atherosclerosis. Int J Mol Sci 2019; 20: 3561.
- Qu B, Qu T. Causes of changes in carotid intima-media thickness: a literature review. Cardiovasc Ultrasound 2015; 13: 46.
- Gimbrone MA, Jr., Garcia-Cardena G. Endothelial cell dysfunction and the pathobiology of atherosclerosis. Circ Res 2016; 118: 620-36.
- Park KH, Park WJ. Endothelial dysfunction: clinical implications in cardiovascular disease and therapeutic approaches. J Korean Med Sci 2015; 30: 1213-25.
- Cicchitto G, Musella V, Acitorio M, et al. Idiopathic pulmonary fibrosis and coronary artery disease. Multidiscip Respir Med 2014; 9: 31.
- Panagiotou M, Church AC, Johnson MK, Peacock AJ. Pulmonary vascular and cardiac impairment in interstitial lung disease. Eur Respir Rev 2017; 26: 16053.
- Nathan SD, Basavaraj A, Reichner C, et al. Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis. Respir Med 2010; 104: 1035-41.
- van Cleemput J, Sonaglioni A, Wuyts WA, Bengus M, Stauffer JL, Harari S. Idiopathic pulmonary fibrosis for cardiologists: differential diagnosis, cardiovascular comorbidities, and patient management. Adv Ther 2019; 36: 298-317.
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- Camare C, Pucelle M, Negre-Salvayre A, Salvayre R. Angiogenesis in the atherosclerotic plaque. Redox Biol 2017; 12: 18-34.
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- Ziora D, Jastrzebski D, Adamek M, et al. Circulating concentration of markers of angiogenic activity in patients with sarcoidosis and idiopathic pulmonary fibrosis. BMC Pulm Med 2015; 15: 113.
- Desai O, Winkler J, Minasyan M, Herzog EL. The role of immune and inflammatory cells in idiopathic pulmonary fibrosis. Front Med (Lausanne) 2018; 5: 43.
- Noth I, Wijsenbeek M, Kolb M, et al. Cardiovascular safety of nintedanib in subgroups by cardiovascular risk at baseline in the TOMORROW and INPULSIS trials. Eur Respir J 2019; 54.
- Sonaglioni A, Caminati A, Lipsi R, Lombardo M, Harari S. Association between C-reactive protein and carotid plaque in mild-to-moderate idiopathic pulmonary fibrosis. Intern Emerg Med 2021; 16: 1529-39.
- Elshazly M, Hosny H, Abdel-Hafiz H, Zakaria A, Elkaffas K, Okasha N. Assessment of endothelial dysfunction in idiopathic pulmonary fibrosis. Egypt J Chest Dis Tuberculosis 2013; 62: 589-92.
- Ozturk K, Guler AK, Cakir M, et al. Pulse wave velocity, intima media thickness, and flow-mediated dilatation in patients with normotensive normoglycemic inflammatory bowel disease. Inflamm Bowel Dis 2015; 21: 1314-20.
- Fois AG, Paliogiannis P, Sotgia S, et al. Evaluation of oxidative stress biomarkers in idiopathic pulmonary fibrosis and therapeutic applications: a systematic review. Respir Res 2018; 19: 51.
- Silva BR, Pernomian L, Bendhack LM. Contribution of oxidative stress to endothelial dysfunction in hypertension. Front Physiol 2012; 3: 441.
- Aslan AN, Ozcan AN, Ayhan H, et al. Evaluation of local carotid stiffness and inflammatory biomarkers in stable angina pectoris. Postepy Kardiol Interwencyjnej 2017; 13: 122-9.
- Koelwyn GJ, Corr EM, Erbay E, Moore KJ. Regulation of macrophage immunometabolism in atherosclerosis. Nat Immunol 2018; 19: 526-37.
- Badimon L, Pena E, Arderiu G, et al. C-reactive protein in atherothrombosis and angiogenesis. Front Immunol 2018; 9: 430.
- Cainzos-Achirica M, Rampal S, Chang Y, et al. Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: the Kangbuk Samsung Health Study. Atherosclerosis 2015; 241: 350-6.
- Lee J-Y, Ryu S, Lee SH, et al. Association between brachial-ankle pulse wave velocity and progression of coronary artery calcium: a prospective cohort study. Cardiovascular diabetology 2015; 14: 147.
- Cinarka H, Kayhan S, Gumus A, et al. Arterial stiffness measured via carotid femoral pulse wave velocity is associated with disease severity in COPD. Respir Care 2014; 59: 274-80.
- Bacha NC, Blandinieres A, Rossi E, et al. Endothelial microparticles are associated to pathogenesis of idiopathic pulmonary fibrosis. Stem Cell Rev Rep 2018; 14: 223-35.
- Magro CM, Waldman WJ, Knight DA, et al. Idiopathic pulmonary fibrosis related to endothelial injury and antiendothelial cell antibodies. Hum Immunol 2006; 67: 284-97.
Cardiovascular risk assessment with pulse wave velocity, intima media thickness, and flow-mediated dilatation in patients with idiopathic pulmonary fibrosis
Abstract
Aim: The underlying mechanism of fibrotic lung diseases predisposing to coronary artery disease is not yet clear. Chronic inflammation may contribute to atherosclerosis and play a role in increased cardiovascular risk. To study investigate subclinical atherosclerosis by measuring carotid femoral pulse wave velocity (PWV), carotid intima media thickness (CIMT), and flow-mediated dilatation (FMD) in patients with idiopathic pulmonary fibrosis (IPF).
Material and Method: This cross-sectional study consisted of 55 newly diagnosed IPF patients and 55 healthy controls between September 2019 and September 2021. Cardiovascular Risk Assessment was evaluated by endothelial function measured by FMD, CIMT measured by carotid doppler ultrasonography, and arterial stiffness measured by PWV.
Results: In multivariable regression models, the presence of IPF was common independent predictor of CIMT (β±SE=0.18±0.05, p=0.002), log(FMD) (β±SE=–0.15±0.04, p<0.001) and log(PWD) (β±SE=0.16±0.03, p<0.001). An increase log(PWV) levels were common independent predictors of CIMT and log(FMD). The levels of CRP were positively correlated with CIMT (r=0.359, p=0.009) and PWV (r=0.338, p=0.018) levels, while it was negatively correlated with FMD levels (r=-0.372, p=0.004).
Conclusions: IPF patients have elevated risk of endothelial dysfunction and atherosclerosis. A sustained inflammatory response may have play an important role in the process of atherosclerosis.
References
- Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of idiopathic pulmonary fibrosis. an official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 198: e44-e68.
- Agrawal A, Verma I, Shah V, Agarwal A, Sikachi RR. Cardiac manifestations of idiopathic pulmonary fibrosis. Intractable Rare Dis Res 2016; 5: 70-5.
- Dalleywater W, Powell HA, Hubbard RB, Navaratnam V. Risk factors for cardiovascular disease in people with idiopathic pulmonary fibrosis: a population-based study. Chest 2015; 147: 150-6.
- Kreuter M, Ehlers-Tenenbaum S, Palmowski K, et al. Impact of comorbidities on mortality in patients with idiopathic pulmonary fibrosis. PLoS One 2016; 11: e0151425.
- Summerhill VI, Grechko AV, Yet SF, Sobenin IA, Orekhov AN. The atherogenic role of circulating modified lipids in atherosclerosis. Int J Mol Sci 2019; 20: 3561.
- Qu B, Qu T. Causes of changes in carotid intima-media thickness: a literature review. Cardiovasc Ultrasound 2015; 13: 46.
- Gimbrone MA, Jr., Garcia-Cardena G. Endothelial cell dysfunction and the pathobiology of atherosclerosis. Circ Res 2016; 118: 620-36.
- Park KH, Park WJ. Endothelial dysfunction: clinical implications in cardiovascular disease and therapeutic approaches. J Korean Med Sci 2015; 30: 1213-25.
- Cicchitto G, Musella V, Acitorio M, et al. Idiopathic pulmonary fibrosis and coronary artery disease. Multidiscip Respir Med 2014; 9: 31.
- Panagiotou M, Church AC, Johnson MK, Peacock AJ. Pulmonary vascular and cardiac impairment in interstitial lung disease. Eur Respir Rev 2017; 26: 16053.
- Nathan SD, Basavaraj A, Reichner C, et al. Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis. Respir Med 2010; 104: 1035-41.
- van Cleemput J, Sonaglioni A, Wuyts WA, Bengus M, Stauffer JL, Harari S. Idiopathic pulmonary fibrosis for cardiologists: differential diagnosis, cardiovascular comorbidities, and patient management. Adv Ther 2019; 36: 298-317.
- Tarbell J, Mahmoud M, Corti A, Cardoso L, Caro C. The role of oxygen transport in atherosclerosis and vascular disease. J R Soc Interface 2020; 17: 20190732.
- Camare C, Pucelle M, Negre-Salvayre A, Salvayre R. Angiogenesis in the atherosclerotic plaque. Redox Biol 2017; 12: 18-34.
- Cui A, Anhenn O, Theegarten D, et al. Angiogenic and angiostatic chemokines in idiopathic pulmonary fibrosis and granulomatous lung disease. Respiration 2010; 80: 372-8.
- Ziora D, Jastrzebski D, Adamek M, et al. Circulating concentration of markers of angiogenic activity in patients with sarcoidosis and idiopathic pulmonary fibrosis. BMC Pulm Med 2015; 15: 113.
- Desai O, Winkler J, Minasyan M, Herzog EL. The role of immune and inflammatory cells in idiopathic pulmonary fibrosis. Front Med (Lausanne) 2018; 5: 43.
- Noth I, Wijsenbeek M, Kolb M, et al. Cardiovascular safety of nintedanib in subgroups by cardiovascular risk at baseline in the TOMORROW and INPULSIS trials. Eur Respir J 2019; 54.
- Sonaglioni A, Caminati A, Lipsi R, Lombardo M, Harari S. Association between C-reactive protein and carotid plaque in mild-to-moderate idiopathic pulmonary fibrosis. Intern Emerg Med 2021; 16: 1529-39.
- Elshazly M, Hosny H, Abdel-Hafiz H, Zakaria A, Elkaffas K, Okasha N. Assessment of endothelial dysfunction in idiopathic pulmonary fibrosis. Egypt J Chest Dis Tuberculosis 2013; 62: 589-92.
- Ozturk K, Guler AK, Cakir M, et al. Pulse wave velocity, intima media thickness, and flow-mediated dilatation in patients with normotensive normoglycemic inflammatory bowel disease. Inflamm Bowel Dis 2015; 21: 1314-20.
- Fois AG, Paliogiannis P, Sotgia S, et al. Evaluation of oxidative stress biomarkers in idiopathic pulmonary fibrosis and therapeutic applications: a systematic review. Respir Res 2018; 19: 51.
- Silva BR, Pernomian L, Bendhack LM. Contribution of oxidative stress to endothelial dysfunction in hypertension. Front Physiol 2012; 3: 441.
- Aslan AN, Ozcan AN, Ayhan H, et al. Evaluation of local carotid stiffness and inflammatory biomarkers in stable angina pectoris. Postepy Kardiol Interwencyjnej 2017; 13: 122-9.
- Koelwyn GJ, Corr EM, Erbay E, Moore KJ. Regulation of macrophage immunometabolism in atherosclerosis. Nat Immunol 2018; 19: 526-37.
- Badimon L, Pena E, Arderiu G, et al. C-reactive protein in atherothrombosis and angiogenesis. Front Immunol 2018; 9: 430.
- Cainzos-Achirica M, Rampal S, Chang Y, et al. Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: the Kangbuk Samsung Health Study. Atherosclerosis 2015; 241: 350-6.
- Lee J-Y, Ryu S, Lee SH, et al. Association between brachial-ankle pulse wave velocity and progression of coronary artery calcium: a prospective cohort study. Cardiovascular diabetology 2015; 14: 147.
- Cinarka H, Kayhan S, Gumus A, et al. Arterial stiffness measured via carotid femoral pulse wave velocity is associated with disease severity in COPD. Respir Care 2014; 59: 274-80.
- Bacha NC, Blandinieres A, Rossi E, et al. Endothelial microparticles are associated to pathogenesis of idiopathic pulmonary fibrosis. Stem Cell Rev Rep 2018; 14: 223-35.
- Magro CM, Waldman WJ, Knight DA, et al. Idiopathic pulmonary fibrosis related to endothelial injury and antiendothelial cell antibodies. Hum Immunol 2006; 67: 284-97.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles [en] Araştırma Makaleleri [tr] |
| Authors | |
| Publication Date | March 27, 2023 |
| Published in Issue | Year 2023 Volume: 4 Issue: 2 |
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TR DİZİN ULAKBİM and International Indexes (1d)
Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]
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