PMID- 16168284
OWN - NLM
STAT- MEDLINE
DCOM- 20051222
LR  - 20220317
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 46
IP  - 6
DP  - 2005 Sep 20
TI  - Flow-mediated vasodilation predicts outcome in patients with chronic heart 
      failure: comparison with B-type natriuretic peptide.
PG  - 1011-8
AB  - OBJECTIVES: The aim of this study was to assess the predictive potency of 
      impaired endothelium-dependent flow-mediated vasodilation (FMD) in patients with 
      chronic heart failure (CHF). BACKGROUND: Chronic heart failure is associated with 
      reduced FMD; the prognostic impact of this observation is unknown. METHODS: 
      Seventy-five ambulatory CHF patients (United Network of Organ Sharing [UNOS] 
      status 2) with a left ventricular ejection fraction (LVEF) < or =30%, despite 
      optimized medical therapy (angiotensin-converting enzyme inhibitor or angiotensin 
      II receptor blocker, 100%; beta-blocker, 81%), were evaluated. Using 
      high-resolution ultrasound, FMD of the brachial artery was assessed in addition 
      to other neurohormonal, clinical, and hemodynamic variables. Age, gender, New 
      York Heart Association (NYHA) functional class, LVEF, hemodynamic variables, 
      B-type natriuretic peptide (BNP) levels, medical therapy, cardiovascular risk 
      factors, and FMD were analyzed for prediction of the combined end point 
      conversion to UNOS status 1 or death in a multivariate Cox model. RESULTS: Up to 
      three years, 21 patients (28%) converted to UNOS status 1, and 6 patients (8%) 
      died. Univariate risk factors for the combined end point were log BNP (p = 
      0.0032), FMD (p = 0.0033), NYHA functional class (p = 0.0132), beta-blocker 
      therapy (p = 0.0367), and mean blood pressure (p = 0.0406). In the multivariate 
      analysis, only FMD (p = 0.0007), log BNP (p = 0.0032), and mean blood pressure (p 
      = 0.0475) were independently related to the combined end point. In the 
      Kaplan-Meier plot, significantly more patients with FMD <6.8% (median) reached 
      the combined end point, as compared with patients with FMD >6.8% (p = 0.004). 
      CONCLUSIONS: In CHF, impaired FMD is a strong, independent predictor of 
      conversion to UNOS status 1 or death.
FAU - Meyer, Brigitte
AU  - Meyer B
AD  - Department of Cardiology, Medical University of Vienna, Vienna, Austria.
FAU - Mortl, Deddo
AU  - Mortl D
FAU - Strecker, Karin
AU  - Strecker K
FAU - Hulsmann, Martin
AU  - Hulsmann M
FAU - Kulemann, Vanessa
AU  - Kulemann V
FAU - Neunteufl, Thomas
AU  - Neunteufl T
FAU - Pacher, Richard
AU  - Pacher R
FAU - Berger, Rudolf
AU  - Berger R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Chronic Disease
MH  - Female
MH  - Heart Failure/*blood/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Prognosis
MH  - Regional Blood Flow
MH  - Ultrasonography
MH  - Vasodilation
EDAT- 2005/09/20 09:00
MHDA- 2005/12/24 09:00
CRDT- 2005/09/20 09:00
PHST- 2004/11/24 00:00 [received]
PHST- 2005/04/04 00:00 [revised]
PHST- 2005/04/13 00:00 [accepted]
PHST- 2005/09/20 09:00 [pubmed]
PHST- 2005/12/24 09:00 [medline]
PHST- 2005/09/20 09:00 [entrez]
AID - S0735-1097(05)01399-9 [pii]
AID - 10.1016/j.jacc.2005.04.060 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2005 Sep 20;46(6):1011-8. doi: 10.1016/j.jacc.2005.04.060.