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Cardiac functions and aortic elasticity in children with inflammatory bowel disease: effect of age at disease onset

Published online by Cambridge University Press:  22 January 2020

Elif Erolu*
Affiliation:
Departmant of Pediatrics, Division of Pediatric Cardiology, Istanbul Health Sciences University, Umraniye Education and Research Hospital, Istanbul, Turkey
Esra Polat
Affiliation:
Departmant of Pediatrics, Division of Pediatric Gastroenterology, Istanbul Health Sciences University, Umraniye Education and Research Hospital, Istanbul, Turkey
*
Author for correspondence: E. Erolu, Elmalıkent Mahallesi, Adem Yavuz Cd., 34764 Istanbul, Turkey. Tel: +905058169456; Fax: (+90216) 632 71 24/(+90216) 632 71 21; E-mail: [email protected]

Abstract

Aim:

Childhood onset inflammatory bowel disease is more aggressive and has rapidly progressive clinical course than adult inflammatory bowel disease. Early-onset inflammatory bowel disease has more severe clinical progression as a subspecialised group of monogenic inflammatory bowel disease. We studied cardiac functions and aortic elasticity in children with early- and late-onset inflammatory bowel disease in remission period.

Methods:

Thirty-three paediatric patients were divided into subgroups according to age of disease onset (<10 and >10 years of age). Twenty-five healthy children were admitted as control group. M-Mode echocardiography and pulsed wave Doppler echocardiography were performed. Strain, distensibility, stiffness index of ascending, and abdominal aorta were evaluated.

Results:

Interventricular septum (mm) and left ventricular end-systolic diameter were higher (6.9 ± 1.2, 26.2 ± 4.6) in early-onset inflammatory bowel disease patients than control patients (6.1 ± 1.27, 22.7 ± 4.12) (p = 0.050, p = 0.050). Mitral E/E′ ratio and myocardial performance index were increased in inflammatory bowel disease and early-onset inflammatory bowel disease groups than control group (p = 0.046, p = 0.04; p = 0.023, p = 0.033). Diastolic functions were found to be impaired in inflammatory bowel disease and early-onset inflammatory bowel disease groups according to control group, while there was no difference between late-onset inflammatory bowel disease and control groups in terms of diastolic functions. Mitral E/A ratio was lower in inflammatory bowel disease patients and early-onset inflammatory bowel disease patients (1.46 ± 0.32, 1.4 ± 0.21) than control patients (1.70 ± 0.27) (p = 0.013, p = 0.004). Aortic elasticity did not differ between groups.

Conclusion:

Chronic low-grade inflammation has effects on left ventricular diameters and diastolic function in remission period. Aortic elasticity is not affected in our study groups.

Type
Original Article
Copyright
© Cambridge University Press 2020

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References

Conrad, K, Roggenbuck, D, Laass, MW. Diagnosis and classification of ulcerative colitis. Autoimmun Rev 2014; 13: 463466.CrossRefGoogle ScholarPubMed
Laass, MW, Roggenbuck, D, Conrad, K. Diagnosis and classification of Crohn’s disease. Autoimmun Rev 2014; 13: 467471.CrossRefGoogle ScholarPubMed
Yu, YR, Rodriguez, JR. Clinical presentation of Crohn’s, ulcerative colitis, and indeterminate colitis: symptoms, extraintestinal manifestations, and disease phenotypes. Semin Pediatr Surg 2017; 26: 349355.CrossRefGoogle ScholarPubMed
Agrawal, D, Rukkannagari, S, Kethu, S. Pathogenesis and clinical approach to extraintestinal manifestations of inflammatory bowel disease. Minerva Gastroenterol Dietol 2007; 53: 233248.Google ScholarPubMed
Dubowitz, M, Gorard, DA. Cardiomyopathy and pericardial tamponade in ulcerative colitis. Eur J Gastroenterol Hepatol 2001; 13: 12551258.CrossRefGoogle ScholarPubMed
Gaduputi, V, Tariq, H, Kanneganti, K. Abdominal aortitis associated with Crohn disease. Can J Gastroenterol Hepatol 2014; 28: 6970.CrossRefGoogle ScholarPubMed
Branchford, BR, Carpenter, SL. The role of inflammation in venous thromboembolism. Front Pediatr 2018; 23: 142.CrossRefGoogle Scholar
Le Gall, G, Kirchgesner, J, Bejaoui, M, et al. Clinical activity is an independent risk factor of ischemic heart and cerebrovascular arterial disease in patients with inflammatory bowel disease. PLoS One 2018; 31: e0201991.CrossRefGoogle Scholar
Levy, E, Rizwan, Y, Thibault, L, et al. Altered lipid profile, lipoprotein composition, and oxidant and antioxidant status in pediatric Crohn disease. Am J Clin Nutr 2000; 71: 807815.CrossRefGoogle ScholarPubMed
Jahnsen, J, Falch, JA, Mowinckel, P, et al. Body composition in patients with inflammatory bowel disease: a population-based study. Am J Gastroenterol 2003; 98: 15561562.CrossRefGoogle ScholarPubMed
Kıvrak, T, Sunbul, M, Cincin, A, et al. Two-dimensional speckle tracking echocardiography is useful in early detection of left ventricular impairment in patients with Crohn’s disease. Eur Rev Med Pharmacol Sci 2016; 20: 32493254.Google ScholarPubMed
Zanoli, L, Ozturk, K, Cappello, M, et al. Inflammation and aortic pulse wave velocity: a multicenter longitudinal study in patients with inflammatory bowel disease. J Am Heart Assoc. 2019; 8: e010942.CrossRefGoogle ScholarPubMed
Levine, A, Griffiths, A, Markowitz, J, et al. Pediatric modification of the Montreal classification for inflammatory bowel disease: the Paris classification. Inflamm Bowel Dis 2011; 17: 13141321.CrossRefGoogle ScholarPubMed
Turner, D, Otley, AR, Mack, D, et al. Development and evaluation of a Pediatric Ulcerative Colitis Activity Index (PUCAI): a prospective multicenter study. Gastroenterology 2007; 133: 423432.CrossRefGoogle ScholarPubMed
Hyams, J, Markowitz, J, Otley, A, et al. Evaluation of the pediatric crohn disease activity index: a prospective multicenter experience. J Pediatr Gastroenterol Nutr 2005; 41: 416421.CrossRefGoogle ScholarPubMed
Kreuzpaintner, G, Horstkotte, D, Heyll, A, et al. Increased risk of bacterial endocarditis in inflammatory bowel disease. Am J Med 1992; 92: 391395.CrossRefGoogle ScholarPubMed
Roifman, I, Sun, YC, Fedwick, JP, et al. Evidence of endothelial dysfunction in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2009; 7: 175182.CrossRefGoogle ScholarPubMed
Zieman, SJ, Melenovsky, V, Kass, DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol 2005; 25: 932943.CrossRefGoogle ScholarPubMed
Wang, M, Zhang, J, Jiang, LQ, et al. Proinflammatory profile within the grossly normal aged human aortic wall. Hypertension 2007; 50: 219227.CrossRefGoogle ScholarPubMed
Arnett, DK, Evans, GW, Riley, WA. Arterial stiffness a new cardiovascular risk factor. Am J Epidemiol 1994; 140: 669682.CrossRefGoogle ScholarPubMed
Zanoli, L, Rastelli, S, Granata, A, et al. Arterial stiffness in inflammatory bowel disease: a systematic review and meta-analysis. J Hypertens 2016; 34: 822829.CrossRefGoogle ScholarPubMed
Zanoli, L, Boutouyrie, P, Fatuzzo, P, et al. Inflammation and aortic stiffness: an individual participant data meta-analysis in patients with inflammatory bowel disease. J Am Heart Assoc 2017; 6: e007003.CrossRefGoogle ScholarPubMed
Lurz, E, Aeschbacher, E, Carman, N, et al. Pulse wave velocity measurement as a marker of arterial stiffness in pediatric inflammatory bowel disease: a pilot study. Eur J Pediatr 2017; 176: 983987.CrossRefGoogle ScholarPubMed
Noireaud, J, Andriantsitohaina, R. Recent insights in the paracrine modulation of cardiomyocyte contractility by cardiac endothelial cells. Biomed Res Int 2014; 2014: 923805.CrossRefGoogle ScholarPubMed
Balligand, JL, Feron, O, Dessy, C. eNOS activation by physical forces: from short-term regulation of contraction to chronic remodeling of cardiovascular tissues. Physiol Rev 2009; 89: 481534.CrossRefGoogle ScholarPubMed
Smiljić, S, Nestorović, V, Savić, S. Modulatory role of nitric oxide in cardiac performance. Med Pregl 2014; 67: 345352.CrossRefGoogle ScholarPubMed
Chong, AY, Blann, AD, Patel, J, et al. Endothelial dysfunction and damage in congestive heart failure: relation of flow-mediated dilation to circulating endothelial cells, plasma indexes of endothelial damage and brain natriuretic peptide. Circulation 2004; 110: 17941798.CrossRefGoogle ScholarPubMed
Kensuke, E. Clinical importance of endothelial function in arteriosclerosis and ischemic heart disease. Circ J 2002; 66: 529533.Google Scholar
Hensel, KO, Abellan Schneyder, FE, Wilke, L, et al. Speckle tracking stress echocardiography uncovers early subclinical cardiac involvement in pediatric patients with inflammatory bowel diseases. Sci Rep 2017; 7: 2966.CrossRefGoogle ScholarPubMed
Caliskan, Z, Gokturk, HS, Caliskan, M, et al. Impaired coronary microvascular and left ventricular diastolic function in patients with inflammatory bowel disease. Microvasc Res 2015; 97: 2530.CrossRefGoogle ScholarPubMed
Vizzardi, E, Sciatti, E, Bonadei, I, et al. Subclinical cardiac involvement in Crohn’s disease and ulcerative colitis: an echocardiographic case-control study. Panminerva Med 2016; 58: 115120.Google ScholarPubMed
Bragagni, G, Brogna, R, Franceschetti, P, et al. Cardiac involvement in Crohn’s disease: echocardiographic study. J Gastroenterol Hepatol 2007; 22: 1822.CrossRefGoogle ScholarPubMed
Pradeep, K, Bhat, MD, Mahi, L, et al. Usefulness of left ventricular end-systolic dimension by echocardiography to predict reverse remodeling in patients with newly diagnosed severe left ventricular systolic dysfunction. Am J Cardiol 2012; 110: 8387.Google Scholar