Endothelium-dependent and -independent vasodilation is more attenuated in ischaemic than in non-ischaemic heart failure.
OBJECTIVE
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.


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 (Deltad) 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-Deltad = 0.14 +/- 0.06 mm in ischaemic vs. 0.31 +/- 0.10 mm in non-ischaemic CHF (P < 0.0001).


CONCLUSIONS
Endothelium-dependent and -independent vascular response is more attenuated in ischaemic than in non-ischaemic CHF.
Klosinska
Magdalena
M
Medical University of Lodz, Lodz, Poland. mklosinska@op.pl
Rudzinski
Tomasz
T
Grzelak
Piotr
P
Stefanczyk
Ludomir
L
Drozdz
Jaroslaw
J
Krzeminska-Pakula
Maria
M
D001916:Brachial Artery / Q000473:pathology*; D016022:Case-Control Studies; D018450:Disease Progression; D004730:Endothelium, Vascular; D005260:Female; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth; D017202:Myocardial Ischemia; D014661:Vasoconstriction; D014664:Vasodilation