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Vascular endothelial function predicts mortality risk in patients with advanced ischaemic chronic heart failure.
- Source :
- European Journal of Heart Failure; Jun2009, Vol. 11 Issue 6, p588-593, 6p
- Publication Year :
- 2009
-
Abstract
- <bold>Aims: </bold>Endothelial function is impaired in advanced chronic heart failure (ACHF) patients. We explored a possible association between endothelial function and subsequent mortality risk in ACHF. <bold>Methods and Results: </bold>We prospectively assessed brachial flow-mediated dilation (FMD) in 82 consecutive New York Heart Association class IV ischaemic ACHF patients with a mean left ventricular ejection fraction (LVEF) of 22 +/- 3%. Following overnight fasting and discontinuation of all medications for > or = 12 h, percent increase in FMD (%FMD) and nitroglycerin-mediated vasodilation were assessed using linear array ultrasound. All patients were followed for 14 +/- 2 months for adverse cardiovascular events, including death, hospitalization for CHF exacerbation, or myocardial infarction. Patients were divided into two groups: those with an FMD lesser than or equal to the median %FMD of 4.6% (n = 41) and those with an FMD above the median (n = 41). Both groups were comparable regarding cardiovascular risk factors, LVEF, and concomitant medications. During follow-up, 22 (53.6%) patients with FMD lesser than or equal to the median had composite adverse cardiovascular events compared with only eight patients (19.5%) with FMD above the median (P < 0.01). Furthermore, fiver deaths (12.1%) occurred in patients with FMD lesser than or equal to the median, compared with no deaths in patients with FMD above the median (P < 0.03). Cox regression analyses revealed that FMD was an independent predictor for these events. <bold>Conclusion: </bold>Flow-mediated dilation is associated with increased mortality risk in ischaemic ACHF patients. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13889842
- Volume :
- 11
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- European Journal of Heart Failure
- Publication Type :
- Academic Journal
- Accession number :
- 105538996
- Full Text :
- https://doi.org/10.1093/eurjhf/hfp053