Document Detail


Endothelial dysfunction, measured by reactive hyperaemia using strain-gauge plethysmography, is an independent predictor of adverse outcome in heart failure.
MedLine Citation:
PMID:  20354033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In congestive heart failure (CHF), arterial response is regulated by endothelial molecules. The aim of this study was to evaluate whether endothelial dysfunction (ED) was a predictor of outcome in a cohort of patients with heart failure.
METHODS AND RESULTS: Endothelial function was assessed in 242 patients with CHF by forearm reactive hyperaemia measured with intermittent venous occlusion plethysmography using a mercury strain gauge. The main endpoints were: 'total events' (death, heart attack, angina, stroke, NYHA class IV, or hospitalization due to heart failure) analysed using Cox regression for repeated events and 'death'. Patients were followed-up for 5 years. Post-hyperaemia forearm blood flow (PHFABF) was an independent predictor of total events [P = 0.01; hazard ratio [Exp(B)] 0.665, standard error (SE) 0.182]. Risk stratification by basal forearm blood flow (BFABF) showed that patients with basal blood flow above the median (3.03 mL min(-1) 100 mL(-1)) benefited from an increase in PHFABF, whereas in patients with a BFABF below the median, the increase in PHFABF did not diminish the risk of events. There was no relation between variations in PHFABF and death.
CONCLUSION: Post-hyperaemia forearm blood flow, as a measure of ED, is an independent predictor of major events in patients with CHF. A BFABF below the median is more predictive of an increased risk of complications.
Authors:
José R de Berrazueta; Armando Guerra-Ruiz; María Teresa García-Unzueta; Gema Martín Toca; Rocío Sainz Laso; María Sáez de Adana; Miguel A Casanova Martín; Manuel Cobo; Javier Llorca
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-30
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2011-06-02     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  477-83     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Research Unit IFIMAV, Cantabria University, Universitary Hospital Valdecilla, Santander, Spain. joseramon@berrazueta.com
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MeSH Terms
Descriptor/Qualifier:
Cardiography, Impedance
Confidence Intervals
Endothelium, Vascular / pathology*
Female
Forearm / blood supply*
Health Status Indicators
Heart Failure / complications,  diagnosis*,  drug therapy,  mortality
Hemodynamics
Humans
Hyperemia / diagnosis*
Kaplan-Meier Estimate
Male
Middle Aged
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Statistics as Topic
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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