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Trial of Cardiovascular Risk Factor Assessment and Transthoracic Echocardiography Results in Patients with Primary
Katarzyna Napiórkowska-Baran1, Grzegorz Grześk2, Jan Błażejewski3
1Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland. k_napiorko@poczta.fm.
Insights
Patients with primary antibody deficiency (PAD) face increasing cardiovascular disease risks. A study found high rates of lipid disorders and identified new heart pathologies in 28% of patients, highlighting the need for cardiovascular risk reduction.
Area of Science:
- Immunology
- Cardiology
- Public Health
Background:
- Inborn errors of immunity are associated with rising cardiovascular disease (CVD) risks and reduced life expectancy.
- Primary antibody deficiency (PAD) is a common inborn error of immunity, but its cardiovascular implications require further investigation.
- Existing research often overlooks comprehensive cardiovascular risk assessment in PAD patients.
Purpose of the Study:
- To assess cardiovascular risk factors in adult patients with primary antibody deficiency (PAD).
- To evaluate cardiac structure and function using echocardiography in this cohort.
- To determine the prevalence of cardiovascular disease and identify specific risk factors within the PAD population.
Main Methods:
- A cross-sectional study analyzing 94 adult patients with PAD.
- Assessment of cardiovascular risk factors: BMI, lifestyle, smoking, glucose, CRP, lipid profile, uric acid, chronic diseases, and glucocorticoid use.
- Cardiac echocardiography was performed to evaluate heart parameters, with a focus on identifying new pathologies.
Main Results:
- High prevalence of cardiovascular disease (25.5%, mainly hypertension) and risk factors: smoking (10.5%), overweight/obesity (31%), and abnormal blood pressure (6.5%).
- Widespread lipid metabolism disorders (72.5%), including elevated total cholesterol, non-HDL, LDL, and triglycerides, alongside low HDL levels.
- Echocardiography revealed new pathologies in 28% of patients, with regurgitation being the most common finding (92.5% of abnormal echocardiograms).
Conclusions:
- Adult patients with primary antibody deficiency exhibit a significant burden of cardiovascular risk factors and established cardiovascular diseases.
- Lipid metabolism disorders are highly prevalent, necessitating targeted interventions.
- Proactive cardiovascular risk management and regular cardiac screening are crucial for improving long-term outcomes in PAD patients.
Abstract:
The life expectancy and the risk of developing cardiovascular diseases in patients with inborn errors of immunity are systematically increasing. The aim of the study was to assess cardiovascular risk factors and to evaluate the heart in echocardiography in patients with primary antibody deficiency (PAD). Cardiac echography and selected cardiovascular risk factors, including body mass index, sedentary lifestyle, nicotine, glucose, C-reactive protein, lipid profile, uric acid level, certain chronic diseases, and glucocorticoid use, were analyzed in 94 patients >18 years of age with PAD. Of the patients,25.5% had a cardiovascular disease (mostly hypertension, 18%), 10.5% smoked, 17% were overweight, 14% were obese, and 15% were underweight. Abnormal blood pressure was found in 6.5% of the patients. Lipid metabolism disorders were found in 72.5% of in the studied cohort, increased total cholesterol (45.5%), non-high-density lipoprotein (HDL) (51%), low-density lipoprotein (LDL) (47%), and triglycerides (32%) were observed. Furthermore, 28.5% had a decrease in HDL and 9.5% had a history of hyperuricemia. The average number of risk factors was 5 ± 3 for the entire population and 4 ± 2 for those under 40 years of age. Elevated uric acid levels were found de novo in 4% of participants. In particular, 74.5% of the patients had never undergone an echocardiogram with a successful completion rate of 87% among those tested. Among them, 30% showed parameters within normal limits, primarily regurgitation (92.5%). New pathologies were identified in 28% of patients. Prevention in patients with PAD, aimed at reducing cardiovascular risk, should be a priority.
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