Increased augmentation index in patients with cystic fibrosis

Hull, J.H., Garrod, R., Ho, T.B., Knight, R.K., Cockcroft, J.R., Shale, D.J. and Bolton, C.E. (2009) Increased augmentation index in patients with cystic fibrosis. European Respiratory Journal, 34(6), pp. 1322-1328. ISSN (print) 0903-1936


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).Clinically stable adult patients with CF, n=50, mean (SD) age 28.0 (8.2) years, and 26 age, gender and BMI matched controls 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 CRP were also determined.Mean (SD) AIx was greater in patients, 8.5 (11.1) %, than controls, -1.8 (13.1) % (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 log10CRP (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 is maintained.

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