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Proinflammatory indicators and the relevance of echocardiography in children with cystic fibrosis

Published online by Cambridge University Press:  19 May 2023

Ovgu Ozenli Yagci Open the ORCID record for Ovgu Ozenli Yagci [Opens in a new window] ,
Ayşe Sulu Open the ORCID record for Ayşe Sulu [Opens in a new window] ,
Pelin Kosger Open the ORCID record for Pelin Kosger [Opens in a new window] ,
Gonca Kilic Yildirim ,
Hulya Anil ,
Birsen Ucar  and
Koray Harmanci
Ovgu Ozenli Yagci*
Affiliation:
Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
Ayşe Sulu
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
Pelin Kosger
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
Gonca Kilic Yildirim
Affiliation:
Department of Pediatric Nutrition and Metabolism, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
Hulya Anil
Affiliation:
Department of Pediatric Allergy and Immunology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
Birsen Ucar
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
Koray Harmanci
Affiliation:
Department of Pediatric Allergy and Immunology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
*
Corresponding author: Dr O. Ozenli Yagci; Email: ozenliovgu@gmail.com
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Abstract

As the life expectancy improves in cystic fibrosis, cardiac dysfunction is becoming an important risk factor for morbidity and mortality. Here, the association of cardiac dysfunction with proinflammatory markers and neurohormones between cystic fibrosis patients and healthy children was investigated. Echocardiographic measurements of right and left ventricular morphology and functions together with levels of proinflammatory markers and neurohormones (renin, angiotensin-II, and aldosterone) were obtained and analysed in a study group of 21 cystic fibrosis children aged 5–18 years and compared with age- and gender-matched healthy children. It was shown that patients had significantly higher interleukin-6, C-reactive protein, renin and aldosterone levels (p < 0.05), dilated right ventricles, decreased left ventricle sizes, as well as both right and left ventricular dysfunction. These echocardiographic changes correlated with hypoxia, interleukin-1 α, interleukin-6, C-reactive protein, and aldosterone (p < 0.05) levels. The current study revealed that hypoxia, proinflammatory markers, and neurohormones are major determinants of subclinical changes in ventricular morphology and function. While the right ventricle anatomy was affected by cardiac remodeling, the left ventricle changes were induced by right ventricle dilation and hypoxia. A significant but subclinical systolic and diastolic right ventricle dysfunction in our patients was associated with hypoxia and inflammatory markers. Systolic left ventricle function was affected by hypoxia and neurohormones. Echocardiography is a reliable and non-invasive method that is used safely in cystic fibrosis children for screening and detection of cardiac anatomical and functional changes. Extensive studies are needed to determine the time and frequency of screening and treatment suggestions for such changes.

Keywords

Cystic fibrosisechocardiographyproinflammatory indicatorsneurohormoneschildren
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 1 , January 2024 , pp. 73 - 78
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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