Farklı Obstrüksiyon Şiddetlerindeki Kistik Fibrozisli Çocuklarda Mikro ve Makrovasküler Fonksiyonların, Egzersiz Kapasitesi ve Solunum Fonksiyonları İle İlişkisinin Araştırılması

Abstract

Endothelial function, arterial stiffness, and maximal exercise capacity may be affected in children with cystic fibrosis (CF). This study aimed to compare microvascular (endothelial) and macrovascular (arterial stiffness) function in CF children with different severities of obstruction, and to examine their relationship with exercise capacity and pulmonary function. The study included 60 CF children (aged 10-18 years). Based on pulmonary function, the children were classified as obstructed (O-CF) (n=14) and non-obstructed (N-CF) (n=46). Endothelial function (ICAM-1, VCAM-1, E-Selectin, VEGF, ET-1), arterial stiffness (Alx@75, PWV), and maximal exercise capacity (cardiopulmonary exercise test) were evaluated. Endothelial function values (ICAM-1, VCAM-1, E-Selectin, VEGF, ET-1) were similar in both O-CF and N-CF groups (p>0.05). In O-CF children, Alx@75 was significantly higher compared to N-CF children (p<0.05), while PWV values were similar between the two groups (p>0.05). In O-CF children, %VO2peak was significantly lower than in N-CF children (p<0.05). In O-CF children, PWV was significantly correlated with VO2peak (r=0.707, p=0.005). In N-CF children, PWV was correlated with FVC (r=0.406, p=0.005), FEV1 (r=0.388, p=0.008), and VO2peak (r=0.431, p=0.003). Alx@75 was correlated with FVC (r=-0.509, p<0.001), FEV1 (r=- 0.508, p<0.001), and VO2peak (r=-0.479, p=0.001). Arterial stiffness and maximal exercise capacity in CF children are affected by the presence of airflow obstruction. When determining a pulmonary rehabilitation program for children with CF, the evaluation of vascular health should be taken into consideration.