| Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure. | |
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MedLine Citation:
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PMID: 15655134 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Endothelial function is known to be impaired in subjects with chronic heart failure (CHF), but the association between endothelial function and subsequent mortality risk in CHF has not been previously reported. METHODS AND RESULTS: Biomarkers of endothelial function in the systemic arterial circulation (flow-mediated dilation [FMD] in the brachial artery) and the pulmonary circulation (exhaled nitric oxide [NO] production during submaximal exercise) were prospectively assessed in 259 subjects with New York Heart Association class II-III CHF. In subjects with FMD measurements (n=149), there were 12 deaths and 5 urgent transplantations over a median follow-up period of 841 days. In subjects with exhaled NO production measurements (n=110), there were 18 deaths and 1 urgent transplantation over a median follow-up period of 396 days. Both decreased FMD and decreased exhaled NO production were associated with increased risk of death or urgent transplantation after adjustment for other known CHF prognostic factors (age, etiology of CHF, functional class, left ventricular ejection fraction) in Cox multivariate proportional-hazards models (adjusted hazard ratio [HR] estimate for a 1% decrease in FMD=1.20; 95% confidence interval [CI], 1.03 to 1.45; P=0.027; adjusted HR estimate for a 1-ppb/min decrease in exhaled NO production=1.31, 95% CI, 1.01 to 1.69, P=0.04). CONCLUSIONS: Endothelial dysfunction in CHF, as assessed by FMD in the brachial artery and exhaled NO production during submaximal exercise, is associated with an increased mortality risk in subjects with both ischemic and nonischemic CHF. |
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Authors:
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Stuart D Katz; Katarzyna Hryniewicz; Ingrid Hriljac; Kujtim Balidemaj; Clarito Dimayuga; Alhakam Hudaihed; Aleksandr Yasskiy |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. Date: 2005-01-17 |
Journal Detail:
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Title: Circulation Volume: 111 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2005-01-25 Completed Date: 2005-06-22 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 310-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Yale University School of Medicine, 135 College St, Ste 301, New Haven, CT 06510, USA. stuart.katz@yale.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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analysis Blood Flow Velocity Brachial Artery / physiopathology, ultrasonography Breath Tests Chronic Disease Cohort Studies Endothelium, Vascular / physiopathology* Exercise Female Heart Failure / mortality*, physiopathology* Humans Male Middle Aged Nitric Oxide / biosynthesis Regional Blood Flow Risk Survival Analysis Vasodilation |
| Grant Support | |
ID/Acronym/Agency:
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HL K24-04024/HL/NHLBI NIH HHS; HL R01-51433/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 10102-43-9/Nitric Oxide |
| Comments/Corrections | |
Comment In:
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Circulation. 2005 Aug 9;112(6):e84; author reply e84
[PMID:
16087805
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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