Radial, carotid and aortic distensibility in congestive heart failure: Effects of high-dose angiotensin-converting enzyme inhibitor or low-dose association with angiotensin type 1 receptor blockade

Cristina Giannattasio, Felice Achilli, Monica Failla, Anna Capra, Antonella Vincenzi, Franco Valagussa, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The aim of this study was to determine whether in patients with congestive heart failure (CHF) a distensibility (Dist) reduction: 1) similarly occurs in different arteries; 2) is related to CHF severity; and 3) is reversible with treatment. BACKGROUND: Several studies suggest that CHF is accompanied by a reduced arterial Dist. METHODS: We measured diameter in radial artery, carotid artery (CA) and abdominal aorta (AO) by echotracking. Distensibility was obtained by relating it to blood pressure. Data were collected in 30 patients with CHF (New York Heart Association functional class I to III) under standard treatment with diuretic, digitalis and angiotensin-converting enzyme (ACE) inhibitor in whom CHF severity was assessed by maximum oxygen consumption (Vo 2max) percentage and in 30 age- and gender-matched controls. Patients with CHF were then randomized to maintain standard treatment (n = 10), double the ACE inhibitor dose (n = 10) or add an angiotensin II antagonist (n = 10) and restudied after two months. RESULTS: Distensibility was markedly reduced in the CHF group in all three vessels (p <0.01), CA and AO Dist being related to CHF severity (p <0.05). After two months, Dist did not change in the group maintained under standard treatment, but it increased significantly (p <0.05) and similarly when the ACE inhibitor dose was doubled or an angiotensin II antagonist was added. CONCLUSIONS: Congestive heart failure is characterized by a reduction of Dist of large-elastic and middle-sized muscular arteries. The reduction of large-elastic artery Dist is related to the CHF severity. These alterations can be reversed by drugs, effectively interfering with the renin-angiotensin system either at the ACE or at the angiotensin receptor level.

Original languageEnglish
Pages (from-to)1275-1282
Number of pages8
JournalJournal of the American College of Cardiology
Volume39
Issue number8
DOIs
Publication statusPublished - Apr 17 2002

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Angiotensin Type 1 Receptor
Angiotensin-Converting Enzyme Inhibitors
Heart Failure
Arteries
Carotid Arteries
Angiotensin II
Angiotensin Receptors
Radial Artery
Digitalis
Abdominal Aorta
Peptidyl-Dipeptidase A
Therapeutics
Renin-Angiotensin System
Diuretics
Oxygen Consumption
Aorta
Blood Pressure

ASJC Scopus subject areas

  • Nursing(all)

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Radial, carotid and aortic distensibility in congestive heart failure : Effects of high-dose angiotensin-converting enzyme inhibitor or low-dose association with angiotensin type 1 receptor blockade. / Giannattasio, Cristina; Achilli, Felice; Failla, Monica; Capra, Anna; Vincenzi, Antonella; Valagussa, Franco; Mancia, Giuseppe.

In: Journal of the American College of Cardiology, Vol. 39, No. 8, 17.04.2002, p. 1275-1282.

Research output: Contribution to journalArticle

Giannattasio, Cristina ; Achilli, Felice ; Failla, Monica ; Capra, Anna ; Vincenzi, Antonella ; Valagussa, Franco ; Mancia, Giuseppe. / Radial, carotid and aortic distensibility in congestive heart failure : Effects of high-dose angiotensin-converting enzyme inhibitor or low-dose association with angiotensin type 1 receptor blockade. In: Journal of the American College of Cardiology. 2002 ; Vol. 39, No. 8. pp. 1275-1282.
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abstract = "OBJECTIVES: The aim of this study was to determine whether in patients with congestive heart failure (CHF) a distensibility (Dist) reduction: 1) similarly occurs in different arteries; 2) is related to CHF severity; and 3) is reversible with treatment. BACKGROUND: Several studies suggest that CHF is accompanied by a reduced arterial Dist. METHODS: We measured diameter in radial artery, carotid artery (CA) and abdominal aorta (AO) by echotracking. Distensibility was obtained by relating it to blood pressure. Data were collected in 30 patients with CHF (New York Heart Association functional class I to III) under standard treatment with diuretic, digitalis and angiotensin-converting enzyme (ACE) inhibitor in whom CHF severity was assessed by maximum oxygen consumption (Vo 2max) percentage and in 30 age- and gender-matched controls. Patients with CHF were then randomized to maintain standard treatment (n = 10), double the ACE inhibitor dose (n = 10) or add an angiotensin II antagonist (n = 10) and restudied after two months. RESULTS: Distensibility was markedly reduced in the CHF group in all three vessels (p <0.01), CA and AO Dist being related to CHF severity (p <0.05). After two months, Dist did not change in the group maintained under standard treatment, but it increased significantly (p <0.05) and similarly when the ACE inhibitor dose was doubled or an angiotensin II antagonist was added. CONCLUSIONS: Congestive heart failure is characterized by a reduction of Dist of large-elastic and middle-sized muscular arteries. The reduction of large-elastic artery Dist is related to the CHF severity. These alterations can be reversed by drugs, effectively interfering with the renin-angiotensin system either at the ACE or at the angiotensin receptor level.",
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T1 - Radial, carotid and aortic distensibility in congestive heart failure

T2 - Effects of high-dose angiotensin-converting enzyme inhibitor or low-dose association with angiotensin type 1 receptor blockade

AU - Giannattasio, Cristina

AU - Achilli, Felice

AU - Failla, Monica

AU - Capra, Anna

AU - Vincenzi, Antonella

AU - Valagussa, Franco

AU - Mancia, Giuseppe

PY - 2002/4/17

Y1 - 2002/4/17

N2 - OBJECTIVES: The aim of this study was to determine whether in patients with congestive heart failure (CHF) a distensibility (Dist) reduction: 1) similarly occurs in different arteries; 2) is related to CHF severity; and 3) is reversible with treatment. BACKGROUND: Several studies suggest that CHF is accompanied by a reduced arterial Dist. METHODS: We measured diameter in radial artery, carotid artery (CA) and abdominal aorta (AO) by echotracking. Distensibility was obtained by relating it to blood pressure. Data were collected in 30 patients with CHF (New York Heart Association functional class I to III) under standard treatment with diuretic, digitalis and angiotensin-converting enzyme (ACE) inhibitor in whom CHF severity was assessed by maximum oxygen consumption (Vo 2max) percentage and in 30 age- and gender-matched controls. Patients with CHF were then randomized to maintain standard treatment (n = 10), double the ACE inhibitor dose (n = 10) or add an angiotensin II antagonist (n = 10) and restudied after two months. RESULTS: Distensibility was markedly reduced in the CHF group in all three vessels (p <0.01), CA and AO Dist being related to CHF severity (p <0.05). After two months, Dist did not change in the group maintained under standard treatment, but it increased significantly (p <0.05) and similarly when the ACE inhibitor dose was doubled or an angiotensin II antagonist was added. CONCLUSIONS: Congestive heart failure is characterized by a reduction of Dist of large-elastic and middle-sized muscular arteries. The reduction of large-elastic artery Dist is related to the CHF severity. These alterations can be reversed by drugs, effectively interfering with the renin-angiotensin system either at the ACE or at the angiotensin receptor level.

AB - OBJECTIVES: The aim of this study was to determine whether in patients with congestive heart failure (CHF) a distensibility (Dist) reduction: 1) similarly occurs in different arteries; 2) is related to CHF severity; and 3) is reversible with treatment. BACKGROUND: Several studies suggest that CHF is accompanied by a reduced arterial Dist. METHODS: We measured diameter in radial artery, carotid artery (CA) and abdominal aorta (AO) by echotracking. Distensibility was obtained by relating it to blood pressure. Data were collected in 30 patients with CHF (New York Heart Association functional class I to III) under standard treatment with diuretic, digitalis and angiotensin-converting enzyme (ACE) inhibitor in whom CHF severity was assessed by maximum oxygen consumption (Vo 2max) percentage and in 30 age- and gender-matched controls. Patients with CHF were then randomized to maintain standard treatment (n = 10), double the ACE inhibitor dose (n = 10) or add an angiotensin II antagonist (n = 10) and restudied after two months. RESULTS: Distensibility was markedly reduced in the CHF group in all three vessels (p <0.01), CA and AO Dist being related to CHF severity (p <0.05). After two months, Dist did not change in the group maintained under standard treatment, but it increased significantly (p <0.05) and similarly when the ACE inhibitor dose was doubled or an angiotensin II antagonist was added. CONCLUSIONS: Congestive heart failure is characterized by a reduction of Dist of large-elastic and middle-sized muscular arteries. The reduction of large-elastic artery Dist is related to the CHF severity. These alterations can be reversed by drugs, effectively interfering with the renin-angiotensin system either at the ACE or at the angiotensin receptor level.

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