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Interdependence of cardiac and endothelial function in patients with symptomatic chronic heart failure of nonischemic

Timothy J Vittorio1, Ron Zolty, Parveen K Garg

  • 1Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York, USA. t_vittorio@hotmail.com

Echocardiography (Mount Kisco, N.Y.)
|June 3, 2009
PubMed

Insights

Left ventricular ejection fraction (LVEF) and endothelial function are linked in chronic heart failure (CHF) patients. This association is significant in non-ischemic systolic CHF, suggesting a shared therapeutic target.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Heart Failure Research

Background:

  • Endothelial dysfunction is a key issue in chronic heart failure (CHF).
  • Left ventricular (LV) impairment can worsen endothelial function by reducing nitric oxide (NO) bioavailability.
  • Therapeutic strategies targeting endothelial function are increasingly important in CHF management.

Purpose of the Study:

  • To investigate the relationship between left ventricular (LV) systolic function and endothelial function in patients with stable CHF.
  • To determine if LV impairment is associated with impaired brachial artery flow-mediated dilatation (FMD).
  • To explore potential shared mechanisms between cardiac and vascular dysfunction in CHF.

Main Methods:

  • Echocardiography was used to measure left ventricular ejection fraction (LVEF).
  • Vascular ultrasound assessed brachial artery flow-mediated vasodilatation (FMD).
  • Studies were conducted on 30 stable New York Heart Association class II-III CHF patients on optimal medical therapy.

Main Results:

  • A strong positive correlation was observed between LVEF and FMD across all CHF patients (r = 0.64, P<0.001).
  • This significant correlation persisted in patients with non-ischemic CHF (n=19, r=0.66, P=0.002).
  • The correlation was not significant in patients with ischemic CHF (n=11, r=0.27, P=0.42).

Conclusions:

  • Left ventricular ejection fraction (LVEF) and endothelium-dependent nitric oxide (NO) vasodilatation are strongly correlated in stable, non-ischemic systolic CHF.
  • This highlights a reciprocal interaction between cardiac and peripheral vascular function in CHF.
  • The findings support targeting either cardiac or vascular endothelium for systemic benefits in CHF patients.
Abstract

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