Endothelial Dysfunction is a Marker of Systemic Response to the Cardiac Resynchronization Therapy in Heart Failure

Santini, Luca; Capria, A.; Molfetta, Arianna Di; Mahfouz, Karim; Panattoni, Germana; Minni, Valentina; Sergi, Domenico; Forleo, Giovanni B.; Romeo, Francesco

doi:10.1016/j.cardfail.2013.05.001

Cited by 8 publications

(14 citation statements)

References 30 publications

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“…30 The presence of endothelial dysfunction was an independent marker of cardiovascular systemic involvement in HF patients who were unresponsive to optimized pharmacologic modulation. 25,31 In the previous study, 32 CRT was associated with increased CFR in the LAD and this effect was observed almost immediately after switching from right ventricular to biventricular pacing. The effect might contributable to the beneficial action of CRT in the failing heart.…”

Section: Discussionmentioning

confidence: 84%

Endothelial Function Predicts New Hospitalization due to Heart Failure Following Cardiac Resynchronization Therapy

Yufu

Shinohara

Ebata

et al. 2015

Pacing and Clinical Electrophysiology

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Section: Discussionmentioning

confidence: 84%

Endothelial Function Predicts New Hospitalization due to Heart Failure Following Cardiac Resynchronization Therapy

Yufu

Shinohara

Ebata

et al. 2015

Pacing and Clinical Electrophysiology

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“…In a subsequent study of 57 patients, Santini et al 8. found that in a CRT cohort, significant improvement in FMD occurred in both responders and non‐responders at 3, 6, and 12 months although with somewhat greater improvement in the responder group than in the non‐responder group, with these results being only of borderline statistical significance.…”

Section: Discussionmentioning

confidence: 95%

“…Two small studies have shown consistent improvement in microvascular cutaneous reactive hyperaemia post‐CRT insertion,5, 6 while studies of the effects of CRT on large conduit vessels utilizing flow‐mediated [i.e. nitric oxide (NO)‐dependent] dilatation (FMD) have shown conflicting results 7, 8, 9. In this present study, we sought to evaluate the effect of CRT on peripheral vascular function and associated markers of inflammation, as well as vascular and platelet NO signalling, we also examined the effects of CRT on parameters of inflammatory and neurohumoral activation.…”

Section: Introductionmentioning

confidence: 99%

Does cardiac resynchronization therapy restore peripheral circulatory homeostasis?

et al. 2017

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AimsTo evaluate whether peripheral circulatory ‘remodelling’ as measured by changes in vascular compliance and in markers of nitric oxide signalling contributes to patient response to cardiac resynchronization therapy (CRT).Methods and resultsEffects of CRT were evaluated in 33 patients pre‐procedure and 6 months post‐procedure. Peak oxygen consumption, 6 min walk distance, New York Heart Association class, and quality of life score were evaluated. Augmentation index and its interactions with nitric oxide (NO) were evaluated by applanation tonometry. Platelet NO responsiveness and content of thioredoxin‐interacting protein were assessed. Plasma concentrations of N‐terminal proBNP, asymmetric and symmetric dimethylarginine (SDMA), high sensitivity C‐reactive protein, catecholamines, and matrix metalloproteinases‐2 and ‐9 were assessed. Despite significant improvement in 6 min walk distance (P = 0.005), New York Heart Association class (P < 0.001), quality of life (P = 0.001), and all echocardiographic parameters post‐CRT, there were no significant changes in augmentation index measurements, thioredoxin‐interacting protein content, and platelet NO response. Significant falls in N‐terminal proBNP (P = 0.008) and SDMA (P = 0.013; independent of renal function) occurred. Falls in SDMA predicted reduction in high‐sensitivity C‐reactive protein (P = 0.04) and increases in peak oxygen consumption (P = 0.04). There were no correlations between changes in echocardiographic parameters and those in vascular function.ConclusionsThese data suggest that the beneficial effects of CRT over 6 months are independent of any change in peripheral NO‐related signalling. However, there is evidence that suppression of inflammation occurs, and its magnitude predicts extent of clinical improvement.

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“…Sin embargo, al tratarse de insuficiencia cardiaca congestiva (ICC), debemos considerar sobre todo las CE cardiacas, incluyendo las CE de los vasos coronarios, de los capilares intramiocárdicos y del endocardio, donde las CE están directamente en comunicación con los cardiomiocitos. Específicamente, este deterioro endotelial coronario tiene un papel fundamental en la patogénesis de la IC, afectando tanto la resistencia microvascular como la conductancia de los grandes vasos, que se desarrolla en paralelo al deterioro de la contractilidad cardiaca (10) .…”

Section: Evidencia De La Disfunción Endotelial En Icunclassified

Implicaciones del endotelio en la insuficiencia cardiaca

Sanín

Buitrago

2014

An Fac med

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ResumenEl papel del endotelio en la insuficiencia cardíaca (IC) ha sido el centro de intensa investigación, puesto que tiene importantes implicaciones sistémicas expresadas en su efecto vasomotor, hemostático e inflamatorio. Existen diferencias individuales en el patrón de la disfunción endotelial de acuerdo a la etiología y severidad de la IC. La disfunción endotelial tiene un importante valor pronóstico en la IC y, aunque aún necesitamos conocer más aspectos de relevancia clínica, es evidente que esta condición se relaciona con desenlaces negativos en estos pacientes. Estamos a la espera de nuevos agentes farmacéuticos dirigidos específicamente al endotelio vascular. En esta revisión, nuestro objetivo es ofrecer un análisis crítico y contemporáneo de la evidencia disponible sobre las consecuencias patológicas y pronóstico de las anomalías endoteliales que definen el inicio, la historia natural y, en última instancia, los desenlaces en la IC. Palabras clave: Endotelio, implicaciones en falla cardiaca, óxido nítrico, terapia. Abstract The role of the endothelium in heart failure has been the focus of intense research, since it has important biologic implications. There are individual differences in the pattern of endothelial dysfunction according to the etiology and severity of heart failure. Endothelial dysfunction is also associated with negative outcomes. We are eagerly waiting for new pharmacological agents targeted specifically to the vascular endothelium. In this review, we aim to provide a critical analysis of the available evidence on the pathological consequences and prognosis of endothelial abnormalities as related to the onset and natural history of heart failure. Keywords: Endothelium, heart failure, nitric oxide, new agents. An

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Endothelial Dysfunction is a Marker of Systemic Response to the Cardiac Resynchronization Therapy in Heart Failure

Cited by 8 publications

References 30 publications

Endothelial Function Predicts New Hospitalization due to Heart Failure Following Cardiac Resynchronization Therapy

Endothelial Function Predicts New Hospitalization due to Heart Failure Following Cardiac Resynchronization Therapy

Does cardiac resynchronization therapy restore peripheral circulatory homeostasis?

Implicaciones del endotelio en la insuficiencia cardiaca

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