Dynamic vascular changes following intravenous antibiotics in patients with cystic fibrosis

Abstract

The abnormal central haemodynamics evident in adults with CF is modulated with a short intervention of intravenous antibiotics.

Cardiovascular Risk, Myocardial Injury, and Exacerbations of Chronic Obstructive Pulmonary Disease

“…Thus, there may be implications for other conditions with acute on chronic inflammation such as bronchiectasis, inflammatory arthropathies and bowel diseases. Previous studies have shown decreases in arterial stiffness with antibiotic therapy in cystic fibrosis exacerbations (47) and anti-inflammatory therapy in rheumatoid arthritis (48).…”

Heart Involvement in Children and Adults with Cystic Fibrosis: Correlation with Pulmonary Indexes and Inflammation Markers

“…Several studies have documented preserved LV function in the presence of normal or severely impaired RV function. However, one group reported a reduced LV ejection fraction with a diffusely hypokinetic ventricle in 19% of CF patients (four of 17) [30], although most previous reports suggest that LV dysfunction is rare even in patients with severe pulmonary disease [21,22]. We assessed LVEF in resting subjects by 2D-echocardiography and our results indicate that LV involvement seems to occur when a massive right ventricular enlargement is present [23] because of abnormal septal motion and absence of a severe impairment of right ventricle.…”

“…A predictive relationship between circulating highly sensitive C-reactive protein (hs-CRP) and haemodynamic alterations, suggests that systemic inflammation may be relevant [28], although not demonstrating causation. An acute proinflammatory stimulus could be associated with heightened vessel stiffness [29], whereas, anti-inflammatory therapy may favourably alter large artery haemodynamics [30].…”

Left ventricular and aortic dysfunction in cystic fibrosis mice

“…Despite normal blood pressures, Hull et al observed large vessel abnormalities in CF patients that indicated enhanced vascular aging [14]. Recently, Hull et al have shown that decreasing systemic inflammation through short-course IV antibiotics can improve central hemodynamics [15]. It is unclear if systemic inflammation contributes to any of our results, but it is clear that in addition to cardiac function, it is important to elucidate the role of large vessel reactivity and hemodynamics in CF to determine the cardiovascular risk for these patients.…”

“…In contrast, evidence for primary left ventricular dysfunction in CF has been scarce. Recent evidence for increased aortic stiffness in CF children [12] and adults [13-15] has added to the question whether left ventricular dysfunction exists in CF. These studies, coupled with our prior experiments showing CFTR involvement in murine cardiomyocyte contraction [5, 6] led us to hypothesize that loss of CFTR function would lead to primary cardiovascular disturbances independent of lung disease.…”