Premium
Chronic heart failure is associated with vascular remodeling of the brachial artery
Author(s) -
Poelzl Gerhard,
Frick Matthias,
Huegel Heike,
Lackner Benedikt,
Alber Hannes F.,
Mair Johannes,
Herold Manfred,
Schwarzacher Severin,
Pachinger Otmar,
Weidinger Franz
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.04.008
Subject(s) - medicine , heart failure , brachial artery , cardiology , vasodilation , endothelial dysfunction , peripheral , artery , lumen (anatomy) , ventricular remodeling , blood pressure
Aims: Endothelial dysfunction has been shown to correlate with severity of congestive heart failure (CHF) and recent data suggest morphological changes of peripheral vasculature to be associated with the syndrome. We therefore investigated the hypothesis that vascular remodeling is associated with functional changes in peripheral conduit arteries and with systemic overexpression of ET‐1 in patients suffering from CHF. Methods and results: 57 consecutive patients referred to the Innsbruck Heart Failure and Transplantation Program (EF=23±7%) and 16 matched controls (EF=60±5%) were studied. Flow‐mediated vasodilation (FMD), nitroglycerin‐mediated vasodilation (NMD), wall thickness (WT), and incremental elastic modulus ( E inc ) were assessed by high‐resolution ultrasound of the brachial artery. FMD ( P =0.004) and NMD ( P =0.02) were significantly higher in controls as compared to moderate and severe CHF patients. In contrast, brachial artery‐wall thickness (BA‐WT) was increased in severe CHF patients ( P =0.038). BA‐WT was significantly correlated with both FMD ( r =−0.28; P =0.049) and NMD ( r =−0.38; P =0.003), and with the E inc ( r =0.45, P =0.001). Lumen diameter was not different among groups. In patients with BA‐WT>0.31 mm, bigET‐1 was higher compared to BA‐WT<0.31 mm ( P <0.05). Conclusion: CHF is associated with remodeling of the brachial artery, which is characterized by morphological, mechanical and functional changes of the vessel wall. Endothelin‐1 may play a role in the vascular remodeling process.