Impact of left ventricular ejection fraction on endothelial function in patients with coronary artery disease.
BACKGROUND
Endothelial dysfunction is present in patients with coronary artery disease (CAD) or with congestive heart failure.


OBJECTIVE
This study was performed to evaluate the impact of systolic heart function on endothelial function in patients with CAD.


METHODS
The study population consisted of 283 consecutive patients (mean age 59 years, 176 men) undergoing coronary angiography. Endothelial function was assessed by measuring flow-mediated vasodilation (FMD) of the brachial artery.


RESULTS
Patients (n = 236) with an ejection fraction (EF) > or = 55% on routine echocardiogram were younger (mean age 58 vs. 62 years), showed a lower prevalence of diabetes (15 vs. 38%) and myocardial infarction (13 vs. 66%), and showed a higher FMD (4.8 +/- 2.4 vs. 4.0 +/- 2.0%, p < 0.05) than patients (n = 47) with an EF < 55%. The correlation coefficient between FMD/endothelial function and EF/systolic heart function was 0.149 (p < 0.02) in the overall study population. Multivariate analysis showed that of age, gender, frequency of diabetes mellitus, myocardial infarction, and CAD extent, EF was the only significant independent parameter correlating with FMD in patients with CAD.


CONCLUSIONS
Compared with the other tested risk factors, EF surprisingly was the only significant independent parameter correlating with endothelial function in patients with CAD. Our results support the view that endothelial function is an independent prognostic factor in patients with CAD.
Bae
Jang-Ho
JH
Division of Cardiology, College of Medicine, Konyang University Hospital, Daejeon, South Korea. jhbae@kyuh.co.kr
Bassenge
Eberhard
E
Kim
Moo-Hyun
MH
Park
Ki-Rack
KR
Kim
Ki-Young
KY
Synn
Yi-Chul
YC
Schwemmer
Michael
M
D001916:Brachial Artery / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004727:Endothelium / Q000098:blood supply* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D014661:Vasoconstriction; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*