Key result
Antibiotic treatment for acute pulmonary exacerbations in children with cystic fibrosis significantly reduced arterial stiffness, lowering the augmentation index from 41.95% to 30.95%.
Why the study?
Acute exacerbations and chronic inflammation are risk factors for CVD in CF, prompting investigation into the effects of acute exacerbation therapy on arterial stiffness in children with CF.
Does acute exacerbation therapy reduce arterial stiffness in children with cystic fibrosis?
Observational (n=27)
Single-blind
No
Does acute exacerbation therapy reduce arterial stiffness in children with cystic fibrosis?
Treatment of acute pulmonary exacerbations in children with cystic fibrosis significantly reduces arterial stiffness, suggesting that systemic inflammation contributes to vascular changes in this population.
Should not yet change exacerbation management in pediatric cystic fibrosis; hypothesis-generating for inflammation-mediated vascular effects, needing randomized confirmation.
Background/aim: Acute exacerbations and chronic inflammation are risk factors for cardiovascular disease (CVD) in cystic fibrosis (CF) patients. The aim of this study was to investigate the effects of acute exacerbation therapy on arterial stiffness in children with CF. Materials and methods: Augmentation index (Aix) and pulse wave velocity (PWV) were measured before and after treatment and 1 month after the end of treatment in patients with acute exacerbation. The relationship between hemodynamic measurements and c-reactive protein (CRP) and pulmonary function tests (PFTs) was investigated. Results: Measurements before and after treatment were evaluated in 27 patients and were repeated in 21 patients who were clinically stable 1 month following acute exacerbation. There was a significant decrease in CRP and an increase in spirometry parameters after treatment. While no significant difference was found between PWV (P = 0.33), a significant difference for Aix before (41.95 ± 12.96%) and after (30.95 ± 11.47%) treatment and before treatment and stable clinical condition (34.19 ± 14.36%) was obtained (P =0.00, and P =0.01, respectively). No significant difference in heart rate and other hemodynamic measurements was found. Pretreatment Aix is associated with poor clinical condition (PFTs, BMI, and clinical score) and systemic inflammation (CRP) (P <0.05). Conclusion: The decrease of arterial stiffness (Aix) with acute exacerbation treatment in children with CF has been demonstrated. This result shows that systemic inflammation in CF may cause an increase in arterial stiffness and recurrent exacerbations may increase the risk of CVD.
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Öztürk et al. (2020) conducted an observational in Cystic fibrosis with acute pulmonary exacerbation (n=27). Antibiotic therapy for acute pulmonary exacerbation vs. Pre-treatment baseline was evaluated on Augmentation index (Aix) (p=<0.01). Antibiotic treatment for acute pulmonary exacerbations in children with cystic fibrosis significantly reduced arterial stiffness, lowering the augmentation index from 41.95% to 30.95%.
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