PMID- 11282905
OWN - NLM
STAT- MEDLINE
DCOM- 20010524
LR  - 20190623
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 103
IP  - 13
DP  - 2001 Apr 3
TI  - Abnormalities of hemorheological, endothelial, and platelet function in patients 
      with chronic heart failure in sinus rhythm: effects of angiotensin-converting 
      enzyme inhibitor and beta-blocker therapy.
PG  - 1746-51
AB  - BACKGROUND: To investigate the hypothesis that abnormalities of hemorheological 
      (fibrinogen, plasma viscosity), endothelial (von Willebrand factor [vWF]), and 
      platelet (soluble P-selectin) function would exist in patients with chronic heart 
      failure (CHF) who are in sinus rhythm, we conducted a cross-sectional study of 
      120 patients with stable CHF (median ejection fraction 30%). We also hypothesized 
      that ACE inhibitors and beta-blockers would beneficially affect the measured 
      indices. METHODS AND RESULTS: In the cross-sectional analysis, plasma viscosity 
      (P=0.001), fibrinogen (P=0.02), vWF (P<0.0001), and soluble P-selectin (P<0.001) 
      levels were elevated in patients with CHF compared with healthy controls. Women 
      demonstrated greater abnormalities of hemorheological indices and vWF than males 
      (all P<0.05). Plasma viscosity (P=0.009) and fibrinogen (P=0.0014) levels were 
      higher in patients with more severe symptoms (New York Heart Association [NYHA] 
      class III-IV), but there was no relationship with left ventricular ejection 
      fraction. When ACE inhibitors were introduced, there was a reduction in 
      fibrinogen (repeated-measures ANOVA, P=0.016) and vWF (P=0.006) levels compared 
      with baseline. There were no significant changes in hemorheological, endothelial, 
      or platelet markers after the introduction of beta-blocker therapy, apart from a 
      rise in mean platelet count (P<0.001). CONCLUSIONS: Abnormal levels of soluble 
      P-selectin, vWF, and hemorheological indices may contribute to a hypercoagulable 
      state in CHF, especially in female patients and in those with more severe NYHA 
      class. Treatment with ACE inhibitors improved the prothrombotic state in CHF, 
      whereas the addition of beta-blockers did not. These positive effects of ACE 
      inhibitors may offer an explanation for the observed reduction in ischemic events 
      in clinical trials.
FAU - Gibbs, C R
AU  - Gibbs CR
AD  - Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of 
      Medicine, City Hospital, Birmingham, UK.
FAU - Blann, A D
AU  - Blann AD
FAU - Watson, R D
AU  - Watson RD
FAU - Lip, G Y
AU  - Lip GY
LA  - eng
PT  - Clinical Trial
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (P-Selectin)
RN  - 0 (von Willebrand Factor)
RN  - 9001-32-5 (Fibrinogen)
RN  - E7199S1YWR (Lisinopril)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Arrhythmia, Sinus
MH  - Blood Platelets/drug effects/*metabolism/*pathology
MH  - Chronic Disease
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Endothelium, Vascular/drug effects/*metabolism/*pathology
MH  - Female
MH  - Fibrinogen/metabolism
MH  - Heart Diseases/blood/drug therapy/pathology/*physiopathology
MH  - Hematocrit
MH  - Humans
MH  - Lisinopril/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - P-Selectin/*metabolism
MH  - Platelet Count
MH  - Regression Analysis
MH  - Rheology
MH  - Sex Characteristics
MH  - Solubility
MH  - Statistics, Nonparametric
MH  - Viscosity
MH  - von Willebrand Factor/*metabolism
EDAT- 2001/04/03 10:00
MHDA- 2001/06/02 10:01
CRDT- 2001/04/03 10:00
PHST- 2001/04/03 10:00 [pubmed]
PHST- 2001/06/02 10:01 [medline]
PHST- 2001/04/03 10:00 [entrez]
AID - 10.1161/01.cir.103.13.1746 [doi]
PST - ppublish
SO  - Circulation. 2001 Apr 3;103(13):1746-51. doi: 10.1161/01.cir.103.13.1746.