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Updated: Mar 18, 2026
Assessing Endothelial Vasodilator Function with the Endo-PAT 2000
Published on: October 15, 2010
Peripheral endothelial function may predict the effectiveness of beta-blocker therapy in patients with idiopathic
Xudong Xie1, Bifeng Wu1, Yao Chen1
1Department of Cardiology, the First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang, China.
Insights
Peripheral endothelial function, measured by flow-mediated dilation (FMD), can predict beta-blocker effectiveness in patients with idiopathic dilated cardiomyopathy. Higher baseline FMD indicates a better response to beta-blocker therapy and left ventricular reverse remodeling.
Area of Science:
- Cardiology
- Vascular Biology
- Pharmacology
Background:
- Beta-blockers improve outcomes in dilated cardiomyopathy by enhancing left ventricular (LV) function and structure.
- Predicting beta-blocker response in idiopathic dilated cardiomyopathy (IDC) remains challenging.
- Peripheral endothelial function is a potential biomarker for cardiovascular health.
Purpose of the Study:
- To assess if peripheral endothelial function predicts beta-blocker response in IDC patients.
- To determine if endothelial function correlates with left ventricular reverse remodeling (LVRR).
- To evaluate flow-mediated dilation (FMD) as a predictor of therapeutic success.
Main Methods:
- Fifty-two IDC patients underwent baseline brachial artery flow-mediated dilation (FMD) measurement.
- Beta-blocker therapy was initiated and titrated to individual tolerance.
- Left ventricular (LV) function and structure were assessed via echocardiography; positive response defined as ≥10% increase in LVEF, LVRR as ≥10% LVEF increase and ≥15% LVESV decrease.
Main Results:
- Baseline FMD was lower in IDC patients compared to controls.
- 54% of patients showed a positive beta-blocker response, and 40% achieved LVRR.
- Higher baseline FMD significantly predicted positive beta-blocker response and LVRR, with good sensitivity and specificity.
Conclusions:
- Flow-mediated dilation (FMD) is a promising independent predictor of beta-blocker therapy effectiveness in IDC.
- Endothelial function assessment may aid in monitoring treatment response and guiding therapy.
- FMD provides valuable prognostic information in patients with idiopathic dilated cardiomyopathy receiving beta-blockers.
Objectives:
Beta-blockers have improved the prognosis of patients with dilated cardiomyopathy as they improve left ventricular (LV) systolic function and structure, which are crucial for myocardial recovery. However, to date, no accurate methods can predict the effectiveness of β-blocker therapy. Our goal was to evaluate whether peripheral endothelial function could be a useful predictor for β-blocker responses and related LV reverse remodeling (LVRR) in patients with idiopathic dilated cardiomyopathy (IDC).
Methods:
Fifty-two IDC patients were recruited and underwent brachial artery flow-mediated dilation (FMD). Beta-blockers were titrated to doses tolerable for each patient. LV function and structure were measured by echocardiography. A positive response to β-blockers was defined as an increase of ≥10% in LV ejection fraction (LVEF). LVRR was defined as an increase of ≥10% in LVEF and a decrease of ≥15% in LV end-systolic volume (LVESV).
Results:
Baseline FMD was 8.4±3.0% in IDC patients and significantly lower than healthy controls. At three-month follow-up, 54% of patients had a positive β-blocker response and 40% achieved LVRR. Patients with a positive response to β-blockers or with LVRR had significantly higher baseline FMD values than those without. FMD was the most significant predictor of changes in LVEF and LVESV. The sensitivity and specificity of baseline FMD to predict β-blocker responses was 64.3% and 83.3%, respectively, and to predict LVRR was 61.9% and 80.6%, respectively. Beta-blockers themselves did not influence FMD values.
Conclusions:
FMD could serve as an independent predictor for monitoring β-blocker therapy effectiveness in IDC patients.
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