Vascular remodeling indicators and their impact on prognosis in patients with chronic heart failure


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Abstract

Aim. To estimate vascular remodeling indicators and their impact on prognosis in patients with chronic heart failure (CHF). Subjects and methods. The study enrolled 128 patients with prior myocardial infarction and CHF and 40 individuals as a comparison group. Endothelium-dependent and -independent vasodilation (EDV and EIDV) was studied in the reactive hyperemia (RH) test and nitroglycerin (NTG) test. Carotid artery (CA) intima-media thickness (IMT) and great arterial rigidity were studied.Results. As compared to the control subjects, the patients with CHF were found to have EDV and EIVD reductions that were more pronounced in those with Functional Class IV CHF, more CA IMT, and abnormal arterial rigidity. There were relationships of EDV and EIDV to CA IMT (r= -0.30; p=0.02) and aortic pulse wave velocity (APWV) (r= -0.30; p=0.05). Multivariate analysis showed that the risk for cardiovascular events (CVE) in the CHF patients with an APWV of >12 m/sec during a year was 2.02 times higher than in those with an APWV of ≤12 m/sec (relative risk 2.02, 95 confidence interval, 1.01-4.03). Conclusion. APWV is an independent risk factor of CVE in patients with CHF.

About the authors

N A Kosheleva

ГОУ ВПО "Саратовский ГМУ им. В.И. Разумовского" Минздравсоцразвития России

A P Rebrov

ГОУ ВПО "Саратовский ГМУ им. В.И. Разумовского" Минздравсоцразвития России

References

  1. Cohn J.N., Ferrari R., Sharpe N. Cardiac remodeling - concept and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling. J Am Coll Cardiol 2000; 35: 569-582.
  2. Лелюк В.Г., Лелюк С.Э. Ультразвуковая ангиология. М: Реальное время 2003; 336.
  3. Crouse J.R. Imaging atherosclerosis: state of the art. J Lipid Res 2006; 47: 1677-1699.
  4. Vanhoutte P.M. Endothelial dysfunction and atherosclerosis. Eur Heart J 1997;18: E19-E29.
  5. Inoue T., Node K. Vascular Failure: a new clinical entity for vascular disease. Hypertension 2006; 24 (11): 2121-2130.
  6. Pauca A.L., O'Rourke M.F., Kon N.D. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 2001; 38 (4): 932-937.
  7. Bots M.L., Hoes A.W., Koudstaal P.J. et al. Common carotid intima-media thickness and risk of stroke and myocardial infarction. The Rotterdam Study. Circulation 1997; 96: 1432-1437.
  8. Dijk J.M., Algra A., van der Graaf Y. et al. SMART study group. Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study. Eur Heart J 2005; 26 (12): 1213-1220.
  9. Орлова Я.А., Кузьмина А.Е., Масенко В.П. и др. Влияние жесткости артерий на развитие сердечно-сосудистых осложнений при ишемической болезни сердца. Сердце 2009; 12: 11-17.
  10. Национальные Рекомен¬дации ВНОК И ОССН по диагностике и лечению ХСН (второй пересмотр). Сердеч недостат 2007; 1: 4-41.
  11. Guyatt G.H., Sullivan M.J., Thompson P.J. et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J 1985; 132 (8): 919-923.
  12. Lieberman E.H., Gerhard M.D., Uehata A. et al. Flow-induced vasodilation of the human brachial artery is impaired in patients. Am J Cardiol 1996; 78: 22-27.
  13. Затейщикова А.А., Затейщиков Д.А. Эндотелиальная регуляция сосудистого тонуса: методы исследования и клиническое значение. Кардиология 1998; 9: 68-80.
  14. Ghiadoni L., Taddei S., Virdis A. et al. Endothelial function and common carotid artery wall thickening in patients with essential hypertension. Hypertension 1998; 32: 25-32.
  15. Laurent S., Cockcroft J., Van Bortel L. et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588-2605.
  16. Котовская Ю.В., Кобалава Ж.Д. Анализ пульсовой волны: новая жизнь старого метода. Сердце 2008: 3: 133-137.
  17. Thorand B., Baumert J., Doring A. et al. Association of cardiovascular risk factors with markers of endothelial dysfunction in middle-aged men and women. Results from the MONICA/KORA Augsburg Study. Thromb Haemost 2006; 95: 134-141.
  18. Tomiyama H., Koij Y., Yambe M. et al. Brachial-ancle pulse wave velocity is a simple and independent predictor of prognosis in patients with acute coronary syndrome. Circ J 2005; 69: 815-822.
  19. Илюхин О.В., Калганова Е.Л., Лопатин Ю.М. Эластичность и реактивность магистральных артерий у больных ишемической болезнью сердца, осложненной сердечной недостаточностью. Кардиология 2005; 10: 52-53.
  20. Vihert A.M. Atherosclerosis of the aorta and coronary arteries in coronary heart disease. Bull World Health Organ 1976; 53: 585-596.
  21. Farrar D.J., Bond M.G., Riley W.A. et al. Anatomic correlates of aortic pulse wave velocity and carotid artery elasticity during atherosclerosis progression and regression in monkeys. Circulation 2005; 112: 194-199.

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