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Endothelium‐dependent and ‐independent vasodilation is more attenuated in ischaemic than in non‐ischaemic heart failure
Author(s) -
Klosinska Magdalena,
Rudzinski Tomasz,
Grzelak Piotr,
Stefanczyk Ludomir,
Drozdz Jaroslaw,
KrzeminskaPakula Maria
Publication year - 2009
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 - 10.1093/eurjhf/hfp091
Subject(s) - medicine , cardiology , brachial artery , vasodilation , heart failure , vasoconstriction , endothelial dysfunction , blood pressure
Aims Endothelial dysfunction in chronic heart failure (CHF) contributes to vasoconstriction. Underlying atherosclerosis may increase vascular abnormalities in ischaemic CHF. We aimed to compare flow‐mediated dilation (FMD) and nitroglycerin‐mediated dilation (NMD) of the brachial artery between patients with ischaemic and non‐ischaemic CHF. Methods and results A total of 57 patients with systolic CHF participated in the study (mean age 59 ± 8 years, 81% male). Patients were in stable NYHA class II (40 patients, 70%) and III (17 patients, 30%). Ischaemic aetiology of CHF was confirmed by coronary angiography in 34 (60%) patients and ruled out in 23 (40%). Flow‐mediated dilation and NMD of the brachial artery was assessed by high‐resolution ultrasound. Endothelium‐dependent vasodilation was markedly reduced in patients with ischaemic CHF compared with those with non‐ischaemic aetiology of CHF—mean absolute change in artery diameter (Δ d ) 0.09 ± 0.07 mm in ischaemic group vs. 0.18 ± 0.07 mm in non‐ischaemic ( P < 0.0001). Nitroglycerin‐mediated vasodilation was also significantly different—Δ d = 0.14 ± 0.06 mm in ischaemic vs. 0.31 ± 0.10 mm in non‐ischaemic CHF ( P < 0.0001). Conclusion Endothelium‐dependent and ‐independent vascular response is more attenuated in ischaemic than in non‐ischaemic CHF.