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.

Keywords

• cardiovascular disease
• coronary artery disease
• pulmonary fibrosis
• atherosclerosis

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.

Keywords

• kardiyovasküler hastalık
• koroner arter hastalığı
• pulmoner fibroz
• ateroskleroz

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