Endothelial Dysfunction
نویسندگان
چکیده
The study by Akiyama et al. (3), in this issue of the Journal, highlights a potential novel target in HFPEF. In this observational hospital-based study of 321 patients with HFPEF and 173 age-, sex-, and comorbidity-matched controls, endothelial function was assessed using reactive hyperemia peripheral arterial tonometry. Endothelial dysfunction (defined by a reactive hyperemia index below the median value of 0.49) was independently associated with HFPEF, as were higher body mass index and lower glomerular filtration rate. In HFPEF, endothelial dysfunction predicted cardiovascular events over a mean follow-up of 20 months, independently of clinical (age, diabetes, hospitalization, New York Heart Association status), echocardiographic (E/e’, ejection fraction), and neurohormonal (brain natriuretic peptide) factors. Of note, the study population consisted of patients referred to 2 tertiary centers in Japan, was more predominantly male (50%), and had better outcomes than observed in Western cohorts (1). Whether this was due to selection bias or true ethnic differences could not be ascertained. Nonetheless, the strong prognostic significance of endothelial dysfunction in HFPEF suggested that the association was not merely a passive observation, but
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تاریخ انتشار 2012