© 2008 European Society of Cardiology
Venous endothelial function in heart failure: Comparison with healthy controls and effect of clinical compensation
Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences, Federal University of Rio Grande do Sul Porto Alegre, RS, Brazil The Heart Institute (InCor) São Paulo, SP, Brazil
* Corresponding author. Cardiovascular Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Sala 2061, Porto Alegre, RS, 90035-003, Brazil. Tel./fax: +55 51 21018344. E-mail address: lerohde{at}terra.com.br (L.E. Rohde).
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Abstract |
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Background: Endothelial function has been extensively evaluated at the arterial bed in several cardiovascular scenarios. Venous endothelial dysfunction, however, has not been thoroughly explored particularly in heart failure (HF).
Aims: To characterize venous endothelial function in severe HF.
Methods and results: Venous endothelial function was evaluated by the dorsal hand vein technique using a tripod holding a linear variable differential transformer. Dorsal hand veins were pre-constricted with phenylephrine and dose–response curves were constructed after acetylcholine and sodium nitroprusside administration. Maximum vasodilator response to acetylcholine, a marker of endothelium-dependent venodilation, was significantly lower (47±53% versus 102±54%, respectively, p=0.0004) in HF (n=27) patients compared to healthy controls (n=20). No difference in the endothelium-independent venodilator response was observed (p=0.87). Maximum vasodilator response to acetylcholine was also significantly lower on admission compared to the response immediately before hospital discharge in patients with acute decompensated HF (p<0.01). Improvement in venous endothelial function paralleled weight loss (mean difference of –3.8 kg, p<0.01) and improvement in the 6-minute walk test (mean difference of 107 m, p<0.01). There was no significant change in angiotensin-converting enzyme inhibitor or beta-blocker use during hospital stay.
Conclusions: HF patients experience marked endothelium-dependent venous dysfunction with partial recovery during in-hospital management.
Key Words: Heart failure • Endothelial function • Venous
Received February 7, 2008; Revised May 2, 2008; Accepted June 9, 2008
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