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Clinical correlates of endothelial function in chronic heart failure

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Abstract

Objective

There is a close link between heart failure and endothelial dysfunction. Brachial flow-mediated dilation (FMD) is a validated non-invasive measure of endothelial function. The aim of this study was to investigate the clinical correlates of FMD in patients with chronic heart failure (CHF).

Design, setting, patients

We evaluated 60 CHF outpatients (age 62 ± 14 years; 49 males, NYHA class 2.2 ± 0.7, left ventricular ejection fraction, LVEF, 33 ± 8%) taking conventional medical therapy (ACE-inhibitors and/or ARBs 93%, beta-blockers 95%) and in stable clinical conditions.

Main outcome measures

The maximum recovery value of FMD was calculated as the ratio of the change in diameter (maximum-baseline) over the baseline value.

Results

As compared with patients with a higher FMD, those with FMD below the median value (4.3%) were more frequently affected by ischemic cardiopathy (50 vs. 23%; p = 0.032) and diabetes mellitus (20 vs. 3%; p = 0.044), had a higher NYHA class (2.5 ± 0.5 vs. 1.9 ± 0.7; p < 0.001) and NT-proBNP (2,690 ± 3,690 vs. 822 ± 1,060; p = 0.001), lower glomerular filtration rate estimated by Cockcroft-Gault (GFRCG: 63 ± 28 vs. 78 ± 25; p = 0.001) and LVEF (29 ± 8 vs. 37 ± 9; p = 0.001), as well as more frequently showing a restrictive pattern (40 vs. 7%; p = 0.002). In a multivariate regression model (R 2 = 0.48; p < 0.001), FMD remained associated only with the NYHA class (p = 0.039) and diabetes mellitus (p = 0.024).

Conclusions

This study demonstrates that a better functional status and absence of diabetes mellitus are associated to higher FMD regardless of the etiology of the cardiac disease.

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Conflict of interest

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Authors and Affiliations

  1. Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy

    Marco Matteo Ciccone, Massimo Iacoviello, Agata Puzzovivo, Pietro Scicchitano, Francesco Monitillo, Francesco De Crescenzo, Vito Caragnano, Marco Sassara, Giovanni Quistelli, Pietro Guida & Stefano Favale

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  1. Marco Matteo Ciccone
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  2. Massimo Iacoviello
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  3. Agata Puzzovivo
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  4. Pietro Scicchitano
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  5. Francesco Monitillo
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  6. Francesco De Crescenzo
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  7. Vito Caragnano
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  8. Marco Sassara
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  9. Giovanni Quistelli
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  11. Stefano Favale
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Correspondence to Marco Matteo Ciccone.

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Ciccone, M.M., Iacoviello, M., Puzzovivo, A. et al. Clinical correlates of endothelial function in chronic heart failure. Clin Res Cardiol 100, 515–521 (2011). https://doi.org/10.1007/s00392-010-0275-y

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  • DOI: https://doi.org/10.1007/s00392-010-0275-y

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