Document Detail

Relationship of flow-mediated arterial dilation and exercise capacity in older patients with heart failure and preserved ejection fraction.
MedLine Citation:
PMID:  22522508     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Older heart failure patients with preserved ejection fraction (HFpEF) have severely reduced exercise capacity and quality of life. Both brachial artery flow-mediated dilation (FMD) and peak exercise oxygen uptake (peak VO(2)) decline with normal aging. However, uncertainty remains regarding whether FMD is reduced beyond the degree associated with normal aging and if this contributes to reduced peak VO(2) in elderly HFpEF patients.
METHODS: Sixty-six older (70 ± 7 years) HFpEF patients and 47 healthy participants (16 young, 25 ± 3 years, and 31 older, 70 ± 6 years) were studied. Brachial artery diameter was measured before and after cuff occlusion using high-resolution ultrasound. Peak VO(2) was measured using expired gas analysis during upright cycle exercise.
RESULTS: Peak VO(2) was severely reduced in older HFpEF patients compared with age-matched healthy participants (15.2 ± 0.5 vs 19.6 ± 0.6 mL/kg/min, p < .0001), and in both groups, peak VO(2) was reduced compared with young healthy controls (28.5 ± 0.8 mL/kg/min; both p < .0001). Compared with healthy young participants, brachial artery FMD (healthy young, 6.13% ± 0.53%) was significantly reduced in healthy older participants (4.0 ± 0.38; p < .0002) and in HFpEF patients (3.64% ± 0.28%; p < .0001). However, FMD was not different in HFpEF patients compared with healthy older participants (p = .86). Although brachial artery FMD was modestly related to peak VO(2) in univariate analyses (r = .19; p = .048), it was not related in multivariate analyses that accounted for age, gender, and body size.
CONCLUSION: These results suggest that endothelial dysfunction may not be a significant independent contributor to the severely reduced exercise capacity in elderly HFpEF patients.
Mark J Haykowsky; David M Herrington; Peter H Brubaker; Timothy M Morgan; W Gregory Hundley; Dalane W Kitzman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-20
Journal Detail:
Title:  The journals of gerontology. Series A, Biological sciences and medical sciences     Volume:  68     ISSN:  1758-535X     ISO Abbreviation:  J. Gerontol. A Biol. Sci. Med. Sci.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-02-20     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  9502837     Medline TA:  J Gerontol A Biol Sci Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  161-7     Citation Subset:  AIM; IM    
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MeSH Terms
Aging / pathology,  physiology*
Brachial Artery / physiopathology,  ultrasonography
Case-Control Studies
Dilatation, Pathologic
Endothelium, Vascular / physiopathology
Exercise Test
Exercise Tolerance / physiology*
Heart Failure / pathology,  physiopathology*,  ultrasonography
Middle Aged
Oxygen Consumption
Stroke Volume
Young Adult
Grant Support

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