title: Flow-Mediated Vasodilatation and Intima-Media Thickness in Patients with Coexisting Heart Failure and Diabetes Receiving Medical Therapy.
abstract: OBJECTIVE
  Intensive medical treatment of heart failure (HF) patients with diabetes may reduce the endothelial dysfunction and the accelerated atherosclerotic process seen in these patients. To study this, we investigated the endothelial function and the presence of atherosclerosis as measured by flow-mediated vasodilatation (FMD) and intima-media thickness (IMT) in intensively treated patients with coexisting HF and diabetes.
  
  
  METHODS
  FMD of the brachial artery and IMT of the common carotid arteries were determined in 26 patients with systolic HF and diabetes who were in intensive medical therapy, as well as in 19 healthy controls. The two groups were matched according to age and sex. In all subjects left ventricular ejection fraction was measured by two-dimensional echocardiography. Biochemical parameters including serum cholesterol, HDL and LDL, triglyceride, glucose, hemoglobin/hemoglobin-A1C (HbA1C), brain natriuretic peptide (BNP) and N-terminal pro-BNP were also assessed.
  
  
  RESULTS
  Mean FMD and IMT did not differ significantly between patients and controls. Left ventricular ejection fraction was lower in patients compared to controls (P < 0.001). The patients had a higher mean BNP, NT pro-BNP, triglyceride, HbA1C and glucose in comparison to controls. Cholesterol, HDL-cholesterol and LDL-cholesterol were lower in patients compared to controls.
  
  
  CONCLUSIONS
  Intensively treated patients with coexisting systolic HF and diabetes seem to have normal endothelial function as measured by FMD and they have no sign of accelerated atherosclerosis as measured by IMT. This suggests a positive effect of medication on the cardiovascular alterations in this group of patients.
authors: Department of Clinical Physiology, Frederiksberg University Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark.
authors: Lisbeth Vestergaard
authors: LV
authors: Andersen
authors: Department of Clinical Physiology, Frederiksberg University Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark.
authors: Niels
authors: N
authors: Wiinberg
authors: Department of Cardiology, Frederiksberg University Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark.
authors: Christian
authors: C
authors: Tuxen
authors: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital and Cluster for Molecular Imaging, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark. akjaer@sund.ku.dk.
authors: Andreas
authors: A
authors: Kjær
keywords: atherosclerosis; diabetes; diagnostic methods; endothelium; heart failure; intima-media; ultrasound