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

Abstract

Our results suggest that the baseline peripheral endothelial function could predict the long-term outcome of CRT. The results also suggest that improvement of coronary microcirculation might be associated with the better baseline endothelial function.

Peripheral endothelial dysfunction is a novel risk factor for systolic dysfunction and heart failure progression

“…In one study [6] consisting of 362 patients with HFrEF who were followed for 3 years, a significant association was found between PED and HF-related events including the composite of CV death and HF hospitalization. In another study [7] , baseline PED predicted HF-related hospitalization in patients who had implanted cardiac resynchronization therapy for HF. In patients with stage C HF with preserved EF (HFpEF), reduced RH-PAT index was also shown to be an independent predictor of CV events [8] .…”

“…Peripheral endothelial function can be assessed noninvasively by measuring the increase in digital blood flow following upper arm cuff occlusion (reactive hyperemia index, RHI; EndoPAT) [3] , [4] , [5] . Peripheral endothelial dysfunction (PED) has been shown to be associated with stage C HF [6] , [7] , where it is also a prognostic marker and potential therapeutic target [8] , [9] . We previously demonstrated that coronary microvascular endothelial dysfunction is present in patients with stage B HF [10] .…”

Endothelial Dysfunction in Chronic Heart Failure: Assessment, Findings, Significance, and Potential Therapeutic Targets

“…The second study included 34 patients with CHF with systolic dysfunction (of ischemic and non-ischemic etiology) who were treated with cardiac resynchronization therapy for the treatment of advanced HF. Their baseline peripheral endothelial function (RH-PAT) independently predicted hospitalization due to HF progression during a follow-up period of 11 months [41].…”

Endothelial dysfunction and glycocalyx shedding in heart failure: insights from patients receiving cardiac resynchronisation therapy

“…Recently, efforts to understand the mechanisms of benefit associated with CRT have begun to address factors beyond improvement in left ventricular contractile efficiency, turning to possible effects on peripheral vascular function [12][13][14]. It is now known that the integrity of the endothelial glycocalyx layer plays a prominent role in maintenance of vascular endothelial function by modulating vascular permeability, coagulation, vascular tone, and complement activation [15].…”