Clinical correlates of endothelial function in chronic heart failure
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Marco Matteo Ciccone Massimo Iacoviello Agata Puzzovivo Pietro Scicchitano Francesco Monitillo Francesco De Crescenzo Vito Caragnano Marco
- چاپ و سال / کشور: 2011
Description
Objective There is a close link between heart failure and endothelial dysfunction. Brachial flow-mediated dilation (FMD) is a validated non-invasive measure of endothelial function. The aim of this study was to investigate the clinical correlates of FMD in patients with chronic heart failure (CHF). Design, setting, patients Weevaluated 60CHFoutpatients (age 62 ± 14 years; 49 males, NYHA class 2.2 ± 0.7, left ventricular ejection fraction, LVEF, 33 ± 8%) taking conventional medical therapy (ACE-inhibitors and/or ARBs 93%, beta-blockers 95%) and in stable clinical conditions. Main outcome measures The maximum recovery value of FMD was calculated as the ratio of the change in diameter (maximum-baseline) over the baseline value. Results As compared with patients with a higher FMD, those with FMD below the median value (4.3%) were more frequently affected by ischemic cardiopathy (50 vs. 23%; p = 0.032) and diabetes mellitus (20 vs. 3%; p = 0.044), had a higher NYHA class (2.5 ± 0.5 vs. 1.9 ± 0.7; p\ 0.001) and NT-proBNP (2,690 ± 3,690 vs. 822 ± 1,060; p = 0.001), lower glomerular filtration rate estimated by Cockcroft-Gault (GFRCG: 63 ± 28 vs. 78 ± 25; p = 0.001) and LVEF (29 ± 8 vs. 37 ± 9; p = 0.001), as well as more frequently showing a restrictive pattern (40 vs. 7%; p = 0.002). In a multivariate regression model (R2 = 0.48; p\0.001), FMD remained associated only with the NYHA class (p = 0.039) and diabetes mellitus (p = 0.024). Conclusions This study demonstrates that a better functional status and absence of diabetes mellitus are associated to higher FMD regardless of the etiology of the cardiac disease.
Clin Res Cardiol (2011) 100:515–521 DOI 10.1007/s00392-010-0275-y Received: 19 July 2010 / Accepted: 23 December 2010 / Published online: 7 January 2011
