Flow-Mediated Dilation Normalization Predicts Outcome in Chronic Heart Failure Patients

Genta, Franco Tarro; Eleuteri, Ermanno; Temporelli, Pier Luigi; Comazzi, F; Tidu, Massimo; Bouslenko, Zoia; Bertolin, Francesca; Vigorito, Carlo; Giannuzzi, Pantaleo; Giallauria, Francesco

doi:10.1016/j.cardfail.2013.01.014

Cited by 28 publications

(16 citation statements)

References 38 publications

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“…According to our systematic search strategy, 2197 titles were identified from electronic databases, and 3 studies were retrieved via hand searching. After screening the title and abstract, 98 studies were eligible for full text review; of these, 57 were excluded, resulting in 35 FMD studies and 6 RH‐PAT studies being eligible for this meta‐analysis. Overall, these studies comprised data from a total of 17 280 participants with FMD, and 1602 with RH‐PAT.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 16 studies took place in East Asia (China, South Korea, and Japan), 13 studies in Europe (Austria, Denmark, Greece, Italy, Serbia, Spain, and Sweden), and 8 in North America (Canada and United States). Among 35 FMD studies, 13 were derived from a non‐CVD population, and 22 from a CVD population (2 studies reported results of non‐CVD and CVD samples separately). Contrarily, all RH‐PAT studies derived from a CVD population .…”

Section: Resultsmentioning

confidence: 99%

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Prognostic Value of Flow‐Mediated Vasodilation in Brachial Artery and Fingertip Artery for Cardiovascular Events: A Systematic Review and Meta‐Analysis

Matsuzawa

Kwon

Lennon

et al. 2015

JAHA

461

334

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BackgroundEndothelial dysfunction plays a pivotal role in cardiovascular disease progression, and is associated with adverse events. The purpose of this systematic review and meta‐analysis was to investigate the prognostic magnitude of noninvasive peripheral endothelial function tests, brachial artery flow‐mediated dilation (FMD), and reactive hyperemia–‐peripheral arterial tonometry (RH‐PAT) for future cardiovascular events.Methods and ResultsDatabases of MEDLINE, EMBASE, and the Cochrane Library were systematically searched. Clinical studies reporting the predictive value of FMD or RH‐PAT for cardiovascular events were identified. Two authors selected studies and extracted data independently. Pooled effects were calculated as risk ratio (RR) for continuous value of FMD and natural logarithm of RH‐PAT index (Ln_RHI) using random‐effects models. Thirty‐five FMD studies of 17 280 participants and 6 RH‐PAT studies of 1602 participants were included in the meta‐analysis. Both endothelial function tests significantly predicted cardiovascular events (adjusted relative risk [95% CI]: 1% increase in FMD 0.88 [0.84–0.91], P<0.001, 0.1 increase in Ln_RHI 0.79 [0.71–0.87], P<0.001). There was significant heterogeneity in the magnitude of the association across studies. The magnitude of the prognostic value in cardiovascular disease subjects was comparable between these 2 methods; a 1 SD worsening in endothelial function was associated with doubled cardiovascular risk.ConclusionsNoninvasive peripheral endothelial function tests, FMD and RH‐PAT, significantly predicted cardiovascular events, with similar prognostic magnitude. Further research is required to determine whether the prognostic values of these 2 methods are independent of each other and whether an endothelial function–guided strategy can provide benefit in improving cardiovascular outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic Value of Flow‐Mediated Vasodilation in Brachial Artery and Fingertip Artery for Cardiovascular Events: A Systematic Review and Meta‐Analysis

Matsuzawa

Kwon

Lennon

et al. 2015

JAHA

461

334

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“…Recently the FDA also approved LVADs as a destination therapy for individuals that may be ineligible for HTx (17,18). However, somewhat surprisingly, considering the predictive value of assessing vascular function in patients (9–12), to date, there is only one study that has utilized FMD to assess the consequences of LVAD implantation on peripheral vascular health (24). This study by Amir et al (24) revealed that approximately 4 months after surgery, individuals with a first generation pulsatile LVAD exhibited what they considered “normal” vascular function, as measured by FMD.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, evidence of peripheral vascular dysfunction is clinically relevant as patients that are at-risk for cardiovascular events who also exhibit a low flow-mediated dilation (FMD) have increased cardiac morbidity and mortality compared to the at-risk patients with normal or mildly abnormal FMD (9). Additionally, an attenuated FMD is also an independent predictor of hospitalization, left ventricular assist device (LVAD) implantation, heart transplantation (HTx), and ultimately death (10–12). Reactive hyperemia (RH), another research tool used to quantify changes in peripheral vascular function (13,14), has also been linked to reduced microvascular function in HF (15,16).…”

Section: Introductionmentioning

confidence: 99%

Further Peripheral Vascular Dysfunction in Heart Failure Patients With a Continuous-Flow Left Ventricular Assist Device

Witman

Garten

Gifford

et al. 2015

JACC: Heart Failure

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Background Peripheral endothelial function is recognized to be impaired in patients with heart failure with reduced ejection fraction (HFrEF), but the peripheral vascular effects of continuous-flow left ventricular assist device (LVAD) implantation, now employed as either a bridge-to-transplantation or as a destination therapy, remain unclear. Using flow-mediated vasodilation (FMD) and reactive hyperemia (RH), this study aimed to provide greater insight into LVAD-induced changes in peripheral vascular function. Methods and Results Sixty-eight subjects (13 New York Heart Association (NYHA) Class II HFrEF patients, 19 NYHA Class III/IV HFrEF patients, 20 NYHA Class III/IV HFrEF patients post-LVAD implantation, and 16 healthy age-matched controls) underwent FMD and RH testing in the brachial artery with blood flow velocity, artery diameters, and pulsatility index (PI) assessed by ultrasound Doppler. PI was significantly lower in the LVAD group (2.0 ± 0.4) compared to both the HFrEF II, (8.6 ± 0.8) and HFrEF III/IV (8.1 ± 0.9) patients, who, in turn, were significantly lower than the controls (12.8 ± 0.9). Likewise, LVAD %FMD/shear rate (0.09 ± 0.01 %Δ/s−1) was significantly reduced compared to all other groups (controls, 0.24 ± 0.03; HFrEF II, 0.17 ± 0.02 and HFrEF III/IV, 0.13 ± 0.02 %Δ/s−1) and %FMD/shear rate was significantly correlated with PI (r=0.45). RH was unremarkable across groups. Conclusions Although central hemodynamics are improved in patients with HFrEF by a continuous-flow LVAD, peripheral vascular function is further compromised, likely due, at least in part, to the reduction in pulsatility that is a characteristic of such a mechanical assist device.

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“…The core component of CR and secondary prevention programs can be shared, being multi-factorial interventions, with cancer patients: health education, CV risk reduction, stress management, increased physical activity and exercise, healthy diet, optimization of drug therapy. The CR reduces mortality, morbidity and hospitalization, as well as improving exercise capacity, psychological wellbeing and QoL in patients with CVD [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ].…”

Section: Introductionmentioning

confidence: 99%

Oncology and Cardiac Rehabilitation: An Underrated Relationship

Venturini

Iannuzzo

D’Andrea

et al. 2020

JCM

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Cancer and cardiovascular diseases are globally the leading causes of mortality and morbidity. These conditions are closely related, beyond that of sharing many risk factors. The term bidirectional relationship indicates that cardiovascular diseases increase the likelihood of getting cancer and vice versa. The biological and biochemical pathways underlying this close relationship will be analyzed. In this new overlapping scenario, physical activity and exercise are proven protective behaviors against both cardiovascular diseases and cancer. Many observational studies link an increase in physical activity to a reduction in either the development or progression of cancer, as well as to a reduction in risk in cardiovascular diseases, a non-negligible cause of death for long-term cancer survivors. Exercise is an effective tool for improving cardio-respiratory fitness, quality of life, psychological wellbeing, reducing fatigue, anxiety and depression. Finally, it can counteract the toxic effects of cancer therapy. The protection obtained from physical activity and exercise will be discussed in the various stages of the cancer continuum, from diagnosis, to adjuvant therapy, and from the metastatic phase to long-term effects. Particular attention will be paid to the shelter against chemotherapy, radiotherapy, cardiovascular risk factors or new onset cardiovascular diseases. Cardio-Oncology Rehabilitation is an exercise-based multi-component intervention, starting from the model of Cardiac Rehabilitation, with few modifications, to improve care and the prognosis of a patient’s cancer. The network of professionals dedicated to Cardiac Rehabilitation is a ready-to-use resource, for implementing Cardio-Oncology Rehabilitation.

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Flow-Mediated Dilation Normalization Predicts Outcome in Chronic Heart Failure Patients

Cited by 28 publications

References 38 publications

Prognostic Value of Flow‐Mediated Vasodilation in Brachial Artery and Fingertip Artery for Cardiovascular Events: A Systematic Review and Meta‐Analysis

Prognostic Value of Flow‐Mediated Vasodilation in Brachial Artery and Fingertip Artery for Cardiovascular Events: A Systematic Review and Meta‐Analysis

Further Peripheral Vascular Dysfunction in Heart Failure Patients With a Continuous-Flow Left Ventricular Assist Device

Oncology and Cardiac Rehabilitation: An Underrated Relationship

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