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Reactive hyperemia is associated with adverse clinical outcomes in heart failure.

Publication ,  Journal Article
Paine, NJ; Hinderliter, AL; Blumenthal, JA; Adams, KF; Sueta, CA; Chang, PP; O'Connor, CM; Sherwood, A
Published in: Am Heart J
August 2016

INTRODUCTION: Impaired endothelial function, as assessed by brachial artery flow-mediated dilation (FMD), is an established risk factor for cardiovascular events. FMD is impaired in heart failure (HF) patients, but less is known about hyperemic brachial artery flow. We investigated the relationship between FMD and hyperemic flow with adverse clinical outcomes in HF patients. METHODS: Brachial artery FMD and hyperemic flow were assessed in 156 patients (70.5 % Male; 45.5% Caucasian; mean age (± SD) = 56.2 (±12.4) years) with HF and reduced left ventricular ejection fraction (LVEF). Cox proportional hazard models were used to assess the potential explanatory association of FMD and hyperemic flow with the composite outcome of death or cardiovascular hospitalization over a median 5-year follow-up period. RESULTS: Both FMD and hyperemic flow were negatively correlated with age, but unrelated to sex, race, body mass index, LVEF or N-terminal pro-B-Type natriuretic peptide (NT-ProBNP). Reduced hyperemic flow, but not FMD, was associated with an increased risk of death or cardiac hospitalization after controlling for traditional risk factors. CONCLUSION: The association of reduced hyperemic flow with increased risk of adverse clinical outcomes suggests that micro-vascular function may be an important prognostic marker in patients with HF.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2016

Volume

178

Start / End Page

108 / 114

Location

United States

Related Subject Headings

  • Vasodilation
  • Stroke Volume
  • Risk Factors
  • Proportional Hazards Models
  • Prognosis
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Mortality
  • Middle Aged
  • Male
 

Citation

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Paine, N. J., Hinderliter, A. L., Blumenthal, J. A., Adams, K. F., Sueta, C. A., Chang, P. P., … Sherwood, A. (2016). Reactive hyperemia is associated with adverse clinical outcomes in heart failure. Am Heart J, 178, 108–114. https://doi.org/10.1016/j.ahj.2016.05.008
Paine, Nicola J., Alan L. Hinderliter, James A. Blumenthal, Kirkwood F. Adams, Carla A. Sueta, Patricia P. Chang, Christopher M. O’Connor, and Andrew Sherwood. “Reactive hyperemia is associated with adverse clinical outcomes in heart failure.Am Heart J 178 (August 2016): 108–14. https://doi.org/10.1016/j.ahj.2016.05.008.
Paine NJ, Hinderliter AL, Blumenthal JA, Adams KF, Sueta CA, Chang PP, et al. Reactive hyperemia is associated with adverse clinical outcomes in heart failure. Am Heart J. 2016 Aug;178:108–14.
Paine, Nicola J., et al. “Reactive hyperemia is associated with adverse clinical outcomes in heart failure.Am Heart J, vol. 178, Aug. 2016, pp. 108–14. Pubmed, doi:10.1016/j.ahj.2016.05.008.
Paine NJ, Hinderliter AL, Blumenthal JA, Adams KF, Sueta CA, Chang PP, O’Connor CM, Sherwood A. Reactive hyperemia is associated with adverse clinical outcomes in heart failure. Am Heart J. 2016 Aug;178:108–114.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2016

Volume

178

Start / End Page

108 / 114

Location

United States

Related Subject Headings

  • Vasodilation
  • Stroke Volume
  • Risk Factors
  • Proportional Hazards Models
  • Prognosis
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Mortality
  • Middle Aged
  • Male