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Clinical studies in cystic fibrosis
P97 Do intravenous antibiotics influence arterial stiffness in adults with cystic fibrosis?
  1. J H Hull1,
  2. R Garrod2,
  3. T B Ho3,
  4. R K Knight3,
  5. J R Cockcroft4,
  6. D J Shale4,
  7. C E Bolton5
  1. 1Kingston University and St George's Hospital, London, UK
  2. 2Kings College Hospital, London, UK
  3. 3Frimley Park NHS Foundation Trust, Frimley, UK
  4. 4Wales Heart Research Institute Cardiff University, Cardiff, UK
  5. 5NIHR Nottingham Respiratory BMU, Nottingham, UK

Abstract

Introduction and objectives Adults with cystic fibrosis (CF) have evidence of increased arterial stiffness which is associated with a chronic systemic inflammatory status (1). We hypothesised that an intervention which decreased inflammation in patients with CF would improve arterial stiffness and we therefore evaluated a 2-week course of intravenous antibiotics on large artery haemodynamics in adults with CF.

Methods We recruited 18 adult patients with CF immediately preceding (visit 1) and following 14 days of intravenous antibiotics (visit 2); prompted by clinical indication. Arterial stiffness was determined by supine applanation tonometry to obtain augmentation index (AIx) which was heart rate adjusted, and aortic pulse wave velocity (aPWV) (SphygmoCor). In addition, heart rate (HR), blood pressure (BP), spirometry and CRP were measured.

Results Complete data was available for 15 patients (n=3 not suitable); mean (SD) age 28 (6) years and BMI 21.2 (2.4) kg/m2. All but one patient reported symptomatic improvement following treatment. Percent predicted forced expiratory volume in one second (FEV1) improved and CRP was reduced at visit 2 (Abstract P97 Table 1). There was a trend towards reduction in HR (p=0.06) whilst peripheral and central BP and aPWV were similar between visits. However, of particular note, HR adjusted AIx was reduced (Abstract P97 Table 1). The change in AIx was related to FEV1 % predicted (r=0.77) and BMI (r=0.71) at visit 1 (both p<0.01), but not CRP (p=0.13).

Conclusions Intervention with intravenous antibiotics in adults with CF is associated with a reduction in AIx, a composite measure of systemic arterial stiffness and wave reflection. Modulation of systemic inflammation results in beneficial haemodynamic changes that may be key in maintaining cardiovascular health in adults with CF.

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