Radial artery flow-mediated dilatation in heart failure patients: Effects of pharmacological and nonpharmacological treatment

Cristina Giannattasio, Felice Achilli, Alessandra Grappiolo, Monica Failla, Ester Meles, Gaetano Gentile, Ivan Calchera, Anna Capra, Jolanda Baglivo, Antonella Vincenzi, Luigi Sala, Giuseppe Mancia

Research output: Contribution to journalArticlepeer-review

Abstract

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 III) 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 II 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

Original languageEnglish
Pages (from-to)1451-1455
Number of pages5
JournalHypertension
Volume38
Issue number6
Publication statusPublished - 2001

Keywords

  • Angiotensin-converting enzyme inhibitors
  • Endothelium
  • Exercise
  • Flow-mediated dilation
  • Heart failure
  • Receptor, angiotensin II

ASJC Scopus subject areas

  • Internal Medicine

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