Radial artery flow-mediated dilatation in heart failure patients - Effects of pharmacological and nonpharmacological treatment
Radial artery flow-mediated dilatation in heart failure patients - Effects of pharmacological and nonpharmacological treatment
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DOI：
10.1161/hy1201.096528
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发表时间：
2001-12-01
期刊：
影响因子：
8.3
通讯作者：
Mancia, G
中科院分区：
文献类型：
--
作者：
Giannattasio, C;Achilli, F;Mancia, G
充血性心力衰竭（CHF）与血流介导的血管舒张受损相关，反映了内皮功能受损。然而，关于药物或非药物治疗是否以及在多大程度上改善这种损害的信息有限。我们在基线和手部缺血4分钟后通过回声跟踪多普勒设备测量桡动脉直径和血流。其通过由流动和剪切应力的增加介导的NO分泌来增加直径。数据收集自44名接受标准治疗（利尿剂、洋地黄和依那普利，20 mg/d）的CHF患者（纽约心脏协会I级至111级），通过心肺负荷试验评估CHF严重程度，并收集自16名年龄和性别匹配的对照组。CHF患者随后被随机分配至维持（A）2个月的标准治疗（n = 11），（B）双倍ACE抑制剂剂量治疗（n = 11），（C）血管紧张素11拮抗剂（氯沙坦，50 mg/d; n = 11）标准治疗，或（D）每周3次、30分钟的自行车训练标准治疗（n = 11）。在基线时，CHF患者和对照组的桡动脉直径和流量相似; CHF患者在4分钟缺血后，流量增加（-36%）和直径增加（-78%）有中度但显著的损害。2个月后，4组的基线直径和流量保持不变。缺血4分钟后，标准治疗组（A）的桡动脉血流和直径增加。而在其他3组中，与对照组比较，差异有显著性（P
Congestive heart failure (CHF) is associated with an impaired flow-mediated vasodilation that reflects an impaired endothelial function. Limited information is available, however, on whether and to what extent this impairment is improved by pharmacological or nonpharmacological treatment. We measured radial artery diameter and blood flow by an echo-tracking Doppler device both at baseline and after 4 minutes of hand ischemia. which increases diameter through NO secretion mediated by an increase in flow and shear stress. Data were collected from 44 CHF patients (New York Heart Association class I to 111) under standard treatment (diuretic, digitalis, and enalapril, 20 mg/d), in whom CHF severity was assessed by a cardiopulmonary stress test, and from 16 age- and sex-matched controls. CHF patients were then randomized to maintain for (A) 2 months of standard treatment (n = 11), (B) treatment with double the ACE inhibitor dose (n = 11), (C) standard treatment with an angiotensin 11 antagonist (losartan, 50 mg/d; n = 11), or (D) standard treatment with bicycle training for 30 minutes, 3 times a week (n = 11). At baseline, radial artery diameter and flow were similar in CHF patients and controls; CHF patients had a modest although significant impairment in flow increase (-36%) and a striking impairment (-78%) in diameter increase following the 4 minutes of ischemia. After 2 months, baseline diameter and flow remained unaltered in the 4 groups. After the 4 minutes of ischemia, radial artery flow and diameter increased as before in the group under standard treatment (A). whereas in the other 3 groups., the increase was significantly (P