Chronic heart failure is associated with vascular remodeling of the brachial artery.
OBJECTIVE
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.


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 (Einc) 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 Einc (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).


CONCLUSIONS
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.
Poelzl
Gerhard
G
Division of Cardiology, Department of Medicine, University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. gerhard.poelzl@uklibk.ac.at
Frick
Matthias
M
Huegel
Heike
H
Lackner
Benedikt
B
Alber
Hannes F
HF
Mair
Johannes
J
Herold
Manfred
M
Schwarzacher
Severin
S
Pachinger
Otmar
O
Weidinger
Franz
F
D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D016022:Case-Control Studies; D004548:Elasticity; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology
D019332:Endothelin-1