Trial of Cardiovascular Risk Factor Assessment and Transthoracic Echocardiography Results in Patients with Primary Antibody Deficiency
-
Katarzyna Napiórkowska-Baran
,
Grzegorz Grześk
,
Jan Błażejewski
,
Marcin Ziętkiewicz
,
Ewa Więsik-Szewczyk
,
Aleksandra Matyja-Bednarczyk
,
Marta Tykwińska
,
Elżbieta Grześk
,
Jakub Lubański
,
Oskar Schmidt
,
Bartłomiej Szymczak
,
Robert Zacniewski
,
Ewa Szynkiewicz
,
Michał Owsiany
,
Zbigniew Bartuzi
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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2. Ameratunga R, Abolhassani H, Maglione PJ, Edwards ESJ. Editorial: Contemporary challenges in diagnosis and treatment of predominantly antibody deficiency. Front Immunol. 2022;13(8):959720.
3. Azizi G, Hesari MF, Sharifinejad N, Fayyaz F, Chavoshzadeh Z, Mahdaviani SA, et al. The Autoimmune Manifestations in Patients with Genetic Defects in the B Cell Development and Differentiation Stages. J Clin Immunol. 2023;43(4):819-34.
4. Benincasa G, Coscioni E, Napoli C. Cardiovascular risk factors and molecular routes underlying endothelial dysfunction: Novel opportunities for primary prevention. Biochem Pharmacol. 2022;202(14):115108.
5. Alexander Y, Osto E, Schmidt-Trucksäss A, Shechter M, Trifunovic D, Duncker DJ, et al. Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardiology Working Groups on Atherosclerosis and Vascular Biology, Aorta and Peripheral Vascular Diseases, Coronary Pathophysiology and Microcirculation, and Thrombosis. Cardiovasc Res. 2021;117(1):29-42.
6. Drosos GC, Vedder D, Houben E, Boekel L, Atzeni F, Badreh S, et al. EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis. 2022;81(6):768-79.
7. Napiórkowska-Baran K, Więsik-Szewczyk E, Ziętkiewicz M, Matyja-Bednarczyk A, Kołtan S, Bąkowska-Kocik N, et al. Protocols of Standard of Care for Adult Patients with Primary Antibody Deficiencies Will Improve Timing of Diagnosis, Survival, and Quality of Life. Iran J Allergy Asthma Immunol. 2022;21(4):374-87.
8. Bonilla FA, Barlan I, Chapel H, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. J Allergy Clin Immunol Pract. 2016;4(1):38-59.
9. Capra ME, Pederiva C, Viggiano C, De Santis R, Banderali G, Biasucci G. Nutritional Approach to Prevention and Treatment of Cardiovascular Disease in Childhood. Nutrients. 2021;13(7):2359.
10. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care 2016;22 (7 Suppl):s176-85
11. Williams EP et al. Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem. Curr Obes Rep Sep. 2015;4(3):363-70.
12. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Expert Panel, 2013. Executive Summary: Guidelines (2013) for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society Published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a Systematic Review From the The Obesity Expert Panel, 2013. Obesity. (Suppl 2, S5-39. 2014.
13. Ameratunga R. Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders. Allergy Asthma Clin Immunol. 2017;13(4):47.
14. Ameratunga R, Longhurst H, Steele R, Lehnert K, Leung E, Brooks AES, Woon ST. Common Variable Immunodeficiency Disorders, T-Cell Responses to SARS-CoV-2 Vaccines, and the Risk of Chronic COVID-19. J Allergy Clin Immunol Pract. 2021;9(10):3575-83.
15. Ruffner MA; USIDNET Body Weight Group; Sullivan KE. Complications Associated with Underweight Primary Immunodeficiency Patients: Prevalence and Associations Within the USIDNET Registry. J Clin Immunol. 2018;38(3):283-93.
16. Rahman A, Jafry S, Jeejeebhoy K, Nagpal AD, Pisani B, Agarwala R. Malnutrition and Cachexia in Heart Failure. JPEN J Parenter Enteral Nutr. 2016;40(4):475-86.
17. Billingsley HE, Hummel SL, Carbone S. The role of diet and nutrition in heart failure: A state-of-the-art narrative review. Prog Cardiovasc Dis. 2020;63(5):538-51.
18. van der Poorten DK, McLeod D, Ahlenstiel G, Read S, Kwok A, Santhakumar C, et al. Gastric Cancer Screening in Common Variable Immunodeficiency. J Clin Immunol. 2018;38(7):768-77.
19. Swift M, Lukin JL. Breast cancer incidence and the effect of cigarette smoking in heterozygous carriers of mutations in the ataxia-telangiectasia gene. Cancer Epidemiol Biomarkers Prev. 2008;17(11):3188-92.
20. Macpherson ME, Halvorsen B, Yndestad A, Ueland T, Mollnes TE, Berge RK, et al. Impaired HDL Function Amplifies Systemic Inflammation in Common Variable Immunodeficiency. Sci Rep. 2019;9(1):9427.
21. Andrade IGA, de Souza FIS, Fonseca FLA, Aranda CS, Sarni ROS. Selenium-related nutritional status in patients with common variable immunodeficiency: association with oxidative stress and atherosclerosis risk. BMC Immunol. 2021;22(1):31.
22. Yan S, Zhang P, Xu W, Liu Y, Wang B, Jiang T, Hua C, Wang X, Xu D, Sun B. Serum Uric Acid Increases Risk of Cancer Incidence and Mortality: A Systematic Review and Meta-Analysis. Mediators Inflamm. 2015;2015:764250.
23. Gherghina ME, Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA. Uric Acid and Oxidative Stress-Relationship with Cardiovascular, Metabolic, and Renal Impairment. Int J Mol Sci. 2022;23(6):3188.
24. Wang L, Zhang T, Liu Y, Tang F, Xue F. Association of Serum Uric Acid with Metabolic Syndrome and Its Components: A Mendelian Randomization Analysis. Biomed Res Int. 2020;2020:6238693.
25. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-237.
26. Johnston SL, Hill SJ, Lock RJ, Dwight JF, Unsworth DJ, Gompels MM. Echocardiographic abnormalities in primary antibody deficiency. Postgrad Med J. 2004;80(942):214-8.
| Files | ||
| Issue | Vol 23 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v23i2.15323 | |
| Keywords | ||
| Echocardiography Heart disease risk factors Primary immune deficiency Primary prevention Primary antibody deficiency | ||
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How to Cite
1.
Napiórkowska-Baran K, Grześk G, Błażejewski J, Ziętkiewicz M, Więsik-Szewczyk E, Matyja-Bednarczyk A, Tykwińska M, Grześk E, Lubański J, Schmidt O, Szymczak B, Zacniewski R, Szynkiewicz E, Owsiany M, Bartuzi Z. Trial of Cardiovascular Risk Factor Assessment and Transthoracic Echocardiography Results in Patients with Primary Antibody Deficiency. Iran J Allergy Asthma Immunol. 2024;23(2):168-181.
