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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Flow-mediated dilation normalization predicts outcome in chronic heart failure patients
Franco Tarro Genta1, Ermanno Eleuteri, Pier Luigi Temporelli
1Division of Cardiology, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Turin, Italy. franco.tarrogenta@fsm.it
Journal of Cardiac Failure
|April 16, 2013
Summary
Normalized flow-mediated dilation (nFMD) is a strong predictor of adverse outcomes in heart failure (HF) patients. Patients with higher nFMD values (>5 seconds) demonstrated significantly better event-free survival, indicating a better prognosis.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Heart Failure Research
Background:
- Reduced flow-mediated dilation (FMD) is a recognized prognostic indicator in heart failure (HF).
- Brachial artery (BA) diameter can influence FMD measurements.
- A novel normalization method (nFMD) was developed to adjust FMD for BA diameter and peak shear rate (PSR).
Purpose of the Study:
- To assess the prognostic value of normalized flow-mediated dilation (nFMD) in patients with heart failure (HF).
- To determine if nFMD is a stronger predictor of adverse events than traditional FMD.
- To evaluate the relationship between nFMD and outcomes such as cardiac death, heart transplantation, and LVAD implantation.
Main Methods:
- Flow-mediated dilation (FMD), brachial artery diameter, flow velocity (FVD), and peak shear rate (PSR) were measured in 71 HF patients.
- Normalized FMD (nFMD) was calculated as FMD/PSR × 1000.
- Multivariate Cox regression and receiver operating characteristic (ROC) curve analyses were used to evaluate prognostic predictors.
Main Results:
- nFMD emerged as a significant independent predictor of adverse outcomes (cardiac death, heart transplantation, LVAD implantation) in HF patients.
- Higher nFMD values (>5 seconds) were associated with significantly better event-free survival (log-rank test: P < .0001).
- Traditional FMD, PSR, and FVD also predicted unfavorable outcomes, but nFMD showed superior prognostic power.
Conclusions:
- Normalized flow-mediated dilation (nFMD) is a potent and independent predictor of cardiac death, heart transplantation, and LVAD implantation in heart failure patients.
- Patients with nFMD greater than 5 seconds exhibit a significantly better prognosis.
- nFMD offers a refined assessment of vascular function and prognosis in heart failure.
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