Document Detail

Radial, carotid and aortic distensibility in congestive heart failure: effects of high-dose angiotensin-converting enzyme inhibitor or low-dose association with angiotensin type 1 receptor blockade.
MedLine Citation:
PMID:  11955844     Owner:  NLM     Status:  MEDLINE    
objectives; The aim of this study was to determine whether in patients with congestive heart failure (CHF) a distensibility (Dist) reduction: 1) similarly occurs in different arteries; 2) is related to CHF severity; and 3) is reversible with treatment. background: Several studies suggest that CHF is accompanied by a reduced arterial Dist. METHODS: We measured diameter in radial artery, carotid artery (CA) and abdominal aorta (AO) by echotracking. Distensibility was obtained by relating it to blood pressure. Data were collected in 30 patients with CHF (New York Heart Association functional class I to III) under standard treatment with diuretic, digitalis and angiotensin-converting enzyme (ACE) inhibitor in whom CHF severity was assessed by maximum oxygen consumption (VO(2)max) percentage and in 30 age- and gender-matched controls. Patients with CHF were then randomized to maintain standard treatment (n = 10), double the ACE inhibitor dose (n = 10) or add an angiotensin II antagonist (n = 10) and restudied after two months. RESULTS: Distensibility was markedly reduced in the CHF group in all three vessels (p < 0.01), CA and AO Dist being related to CHF severity (p < 0.05). After two months, Dist did not change in the group maintained under standard treatment, but it increased significantly (p < 0.05) and similarly when the ACE inhibitor dose was doubled or an angiotensin II antagonist was added. CONCLUSIONS: Congestive heart failure is characterized by a reduction of Dist of large-elastic and middle-sized muscular arteries. The reduction of large-elastic artery Dist is related to the CHF severity. These alterations can be reversed by drugs, effectively interfering with the renin-angiotensin system either at the ACE or at the angiotensin receptor level.
Cristina Giannattasio; Felice Achilli; Monica Failla; Anna Capra; Antonella Vincenzi; Franco Valagussa; Giuseppe Mancia
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  39     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-16     Completed Date:  2002-05-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1275-82     Citation Subset:  AIM; IM    
Clinica Medica, Department of Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Milano-Bicocca University, Milano, Italy.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Aorta, Abdominal / chemistry*,  drug effects*
Blood Pressure / drug effects,  physiology
Carotid Artery, Common / chemistry*,  drug effects*
Dose-Response Relationship, Drug
Heart Failure / drug therapy*
Heart Rate / drug effects,  physiology
Middle Aged
Radial Artery / chemistry*,  drug effects*
Receptor, Angiotensin, Type 1
Receptors, Angiotensin / administration & dosage*,  antagonists & inhibitors*
Renin / blood,  drug effects
Stroke Volume / drug effects,  physiology
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Receptor, Angiotensin, Type 1; 0/Receptors, Angiotensin; EC

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