Short-term improvement in submaximal exercise capacity by optimized therapy with ACE inhibitors and beta blockers in heart failure patients is associated with restoration of peripheral endothelial function

International Journal of Cardiology
Gerhard PoelzlFranz Weidinger

Abstract

Improved exercise capacity in chronic heart failure (CHF) has been attributed to restoration of endothelial function. ACE inhibitors as well as beta blockers have previously been shown to enhance endothelial function and exercise capacity. The aim of this study was to determine whether short-term improvement in submaximal exercise capacity induced by optimized therapy with ACE inhibitors in combination with beta blockers is associated with restoration of endothelial function in CHF patients. Thirty-three patients with CHF were evaluated: six-minute walk test, NYHA class, brain natriuretic peptide (BNP), big Endothelin-1 (bigET-1) and flow-mediated vasodilation (FMD) of the brachial artery were assessed at baseline and after a 3-month period of optimized neurohormonal therapy. Two groups were formed retrospectively based on the changes in submaximal exercise capacity (responders and non-responders). Optimization of neurohormonal therapy was comparable between groups. Responders (n=17) revealed a significant increase in walking distance (304+/-109 to 441+/-75 m; p<0.01), which was paralleled by a decrease in NYHA class (2.7+/-0.6 to 2.0+/-0.4; p<0.01), BNP (484+/-454 to 243+/-197 pg/ml; p<0.01), and bigET-1 (2.0+/-0.9 vs. 1.5+/-0...Continue Reading

References

Dec 15, 1994·Annals of Internal Medicine·E H LiebermanM A Creager
Dec 16, 1998·Circulation·H Drexler
May 30, 2001·European Journal of Heart Failure·S StewartJ J McMurray
Aug 9, 2001·European Heart Journal·W J RemmeUNKNOWN Task Force for the Diagnosis and Treatment of Chronic Heart Failure, European Society of Cardiology
Jan 24, 2002·Patient Education and Counseling·Anna StrömbergUlf Dahlström
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Jul 14, 2004·European Journal of Endocrinology·Richard D JonesKevin S Channer

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Citations

Jun 9, 2012·European Journal of Heart Failure·Eduard ShantsilaGregory Y H Lip
Feb 13, 2014·Circulation. Heart Failure·Viviane M ConraadsDirk J van Veldhuisen
Apr 10, 2007·American Journal of Physiology. Heart and Circulatory Physiology·Dinender K SinglaTimothy J Kamp
Mar 5, 2010·The American Journal of Clinical Nutrition·Stéphane DoutreleauBernard Geny
Sep 8, 2009·American Journal of Physiology. Heart and Circulatory Physiology·Priscila Abreu SperandioJ Alberto Neder

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