PMID- 20070352
OWN - NLM
STAT- MEDLINE
DCOM- 20100920
LR  - 20161125
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 27
IP  - 3
DP  - 2010 Mar
TI  - Association between endothelial function and chronotropic incompetence in 
      subjects with chronic heart failure receiving optimal medical therapy.
PG  - 294-9
LID - 10.1111/j.1540-8175.2009.01011.x [doi]
AB  - OBJECTIVE: Impairment of flow-mediated, endothelium-dependent vasodilatation 
      (FMD) of the brachial artery identifies peripheral endothelial dysfunction in 
      subjects with chronic congestive heart failure (CHF) and is associated with 
      increased morbidity and mortality. To further elucidate the interaction of 
      peripheral and central mechanisms in the syndrome of CHF, we examined the 
      association between endothelial function and chronotropic incompetence, an 
      emerging prognostic marker in CHF. METHODS: Thirty subjects with stable New York 
      Heart Association (NYHA) functional class II-III CHF were studied. A vascular 
      ultrasound study was performed to measure brachial artery FMD. The percentage of 
      age-adjusted maximal predicted heart rate (MPHR) reached during cardiopulmonary 
      exercise tolerance testing (CPETT) was used to assess the degree of chronotropic 
      competence. All patients received ACE inhibitors and beta-adrenoceptor blockers. 
      RESULTS: Brachial artery FMD averaged 1.3 +/- 2.4% and age-adjusted % MPHR 74.1 
      +/- 11.7%. FMD correlated with % MPHR among all patients (r = 0.60, P = 0.01). 
      FMD and resting heart rate (RHR) did not significantly correlate (r = 0.13, P = 
      0.55). CONCLUSIONS: FMD, a measure of peripheral endothelial dysfunction, and % 
      MPHR, a central determinant of cardiac output, are moderately correlated in heart 
      failure patients receiving optimal medical therapy. Whether a cause-effect 
      relationship underlies this association remains to be investigated.
FAU - Vittorio, Timothy J
AU  - Vittorio TJ
AD  - Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of 
      Medicine, New York, NY 10029-6574, USA.
FAU - Lanier, Gregg
AU  - Lanier G
FAU - Zolty, Ronald
AU  - Zolty R
FAU - Sarswat, Nitasha
AU  - Sarswat N
FAU - Tseng, Chi-Hong
AU  - Tseng CH
FAU - Colombo, Paolo C
AU  - Colombo PC
FAU - Jorde, Ulrich P
AU  - Jorde UP
LA  - eng
PT  - Journal Article
DEP - 20100111
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Brachial Artery/diagnostic imaging
MH  - Endothelium, Vascular/*physiopathology
MH  - Exercise Tolerance
MH  - Female
MH  - Heart Failure/drug therapy/etiology/*physiopathology
MH  - *Heart Function Tests
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Ultrasonography
EDAT- 2010/01/15 06:00
MHDA- 2010/09/21 06:00
CRDT- 2010/01/15 06:00
PHST- 2010/01/15 06:00 [entrez]
PHST- 2010/01/15 06:00 [pubmed]
PHST- 2010/09/21 06:00 [medline]
AID - ECHO1011 [pii]
AID - 10.1111/j.1540-8175.2009.01011.x [doi]
PST - ppublish
SO  - Echocardiography. 2010 Mar;27(3):294-9. doi: 10.1111/j.1540-8175.2009.01011.x. 
      Epub 2010 Jan 11.