Changes Of Endothelium-dependent Vasodilation In Patients With Chronic Heart Failure And Effects Of Sodium Ferulate

Objectives Firstly, to study the changes of flow-mediated endothelium-dependent vasodilation (FMD) in patients with chronic heart failure(CHF) and its relationship to the severity of heart failure; Secondly, to evaluate the effects of non-selective endothelin-1 receptors blocker sodium ferulate on FMD in patients with CHF.Methods Seventy-eight patients with CHF due to ischemic heart failure were divided into three groups according to the standard of New York Heart Association functional class(NYHAFC): GroupFC II (n=26), GroupFCIII(n=28) and GroupFCIV(n=24), 26 normal control subjects were also studied simultaneously(GroupNC). In addition, these patients with CHF were randomized to receive either conventional medication including digitalis, ACE inhibitor and diuretic(n=39) or conventional medication plus sodium ferulaye(300mg/d, n=39) by intravenous infusion for 14 days. Using high resolution ultrasound, FMD and nitroglycerin-mediated dilatation(NMD) of the brachial artery were assessed at baseline in all subjects and after 2 weeks treatment in 78 patients with CHF.Results Compared with normal controls, FMD at baseline was impaired in patients with CHF ( GroupFC II, GroupFCIII, GroupFCIV vs GroupNC, P<0.05 respectively), NMD was only impaired significantly in GroupFCIV(P<0.05). Although NMD was also impaired in GroupFC II and GroupFClII, there was no significant differences(P>0.05 respectively). In comparision with GroupFC II or GroupFClII, FMD was impaired significantly in GroupFClV(P<0.05 respectively), however, FMD was no significant differences between Group FCII and GroupFClII. A significant improvement of FMD was found after 2 weeks of sodium ferulaye treatment(P<0.05) but not after conventional medication ( P>.05 ). NMD remained unchanged in both groups .Conclusions FMD was impaired in patients with CHF due to ischemic heart failure when compared with normal controls. With the increasing severity of heartr failure, FMD also decreased accordingly. There is a correlation between the severity of heart failure and the abnormality of FMD. The degrees of heart failure and the prognosis ofpatients with CHF can be assessed by meaturement in EDD. Short-term intravenous infusion with non-selective ET-1 receptors blocker sodium ferulate could improve FMD in patients with CHF. The mechanism may be related to the blockade of the bind between ET-1 and its receptors.