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Increased augmentation index in patients with cystic fibrosis

¹ Faculty of Health and Social Care Sciences, Kingston University and St George's, London, ² Knight Centre for Cystic Fibrosis, Frimley Park Hospital, Frimley, ³ Dept of Cardiology, School of Medicine, Cardiff University, Wales Heart Research Institute, University Hospital of Wales, Cardiff, and ⁴ Dept of Respiratory Medicine, School of Medicine, Cardiff University, Academic Centre, Llandough Hospital, Penarth, UK.

CORRESPONDENCE: J. H. Hull, Faculty of Health and Social Care Sciences, 2nd floor Grosvenor Wing, St George's Hospital, London, SW17 0RE, UK. E-mail: jiminio{at}doctors.org.uk

Keywords: Arterial stiffness, cystic fibrosis, diabetes mellitus, inflammation

Received: March 17, 2009
Accepted July 7, 2009

Increased large artery stiffness occurs in a range of inflammatory conditions indicating an ageing of the vasculature and additionally being an independent risk factor for cardiovascular events. We determined large artery parameters in adults with cystic fibrosis (CF).

50 clinically stable adult patients with CF (mean±SD age 28.0±8.2 yrs) and 26 controls matched for age, sex and body mass index were studied. Central aortic blood pressure, augmentation index (AIx) and aortic pulse wave velocity (PWV) were determined using applanation tonometry. Lung function, diabetic status and C-reactive protein (CRP) were also determined.

Mean±SD AIx was greater in patients than controls, 8.5±11.1% and -1.8±13.1%, respectively (p<0.001), while PWV was similar. Although AIx was greatest in the sub-group with CF-related diabetes (CFRD), it was also increased in the non-CFRD sub-group when compared with controls. In patients, AIx was related to log₁₀ CRP (r = 0.33) and forced vital capacity (r = -0.34; both p<0.05), and CRP remained predictive in multiple regression.

AIx is increased in adults with CF, in the presence of a normal blood pressure and independent of diabetic status. AIx was related to the systemic inflammatory status. These findings have implications for management and require further exploration so that cardiovascular health can be maintained.