Background: The influence of moderate altitude on the cardiovascular system in patients with metabolic syndrome has not been investigated sufficiently, yet. T he aim of this study was to assess the effect of acute and...Background: The influence of moderate altitude on the cardiovascular system in patients with metabolic syndrome has not been investigated sufficiently, yet. T he aim of this study was to assess the effect of acute and mid-term exposure to moderate altitude(1700 m) on endothelial function in patients with metabolic sy ndrome. Methods: Flow-medi-ated(FMD) and nitroglycerin-mediated vasodilation( NMD) were assessed in 18 patients with coronary risk factors on 5 occasions:(1) at location A(576 m),(2) on the first day at moderate altitude(location B, 1700 m),(3) after 3 weeks at moderate altitude,(4) and(5) again at location A(6 and 1 6 weeks after the stay at moderate altitude, respectively). In addition, markers of lipid metabolism, serum erythropoietin and endothelin were measured. Results : FMD on the first day at moderate altitude was similar compared to baseline FMD at location A(7.0±3.3 vs. 7.4±4.6%; NS). A 3-week stay at moderate altitude was associated with a significant reduction in FMD(7.4±4.6 vs. 3.8±2.5%; p< 0.05) despite a decrease in baseline diameter(4.5±0.3 vs. 4.3±0.4 mm; p< 0.05) . Six weeks after returning to location A, FMD was still reduced compared to bas eline(4.3±2.8%; p< 0.05) and after further 16 weeks, FMD returned to baseline values(5.5±3.5%). However, metabolic parameters improved significantly. In contrast, NMD and endo thelin levels remained unchanged. Conclusion: In patients with metabolic syndrom e, a sojourn of 3 weeks at moderate altitude leads to a prolonged, but reversibl e impairment of FMD. The discrepancy to improvement of other cardiovascular and metabolic parameters requires further investigation.展开更多
Background: 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 endothelia...Background: 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. Methods: 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 nonresponders). Results: 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± 0.6 fmol/ml; p=0.04). By contrast, the latter variables did not change in non-responders. Improvement in functional capacity in responders was associated with an increase in FMD(8.2± 3.9% to 11.0± 5.6% ; p< 0.05). Increments in FMD were directly correlated with increases in walking distance(r=0.34; p< 0.05). Conclusion: Short-term improvement of submaximal exercise capacity in CHF patients following optimized therapy with ACE inhibitors and beta blockers is associated with restoration of endothelial function in conduit arteries.展开更多
文摘Background: The influence of moderate altitude on the cardiovascular system in patients with metabolic syndrome has not been investigated sufficiently, yet. T he aim of this study was to assess the effect of acute and mid-term exposure to moderate altitude(1700 m) on endothelial function in patients with metabolic sy ndrome. Methods: Flow-medi-ated(FMD) and nitroglycerin-mediated vasodilation( NMD) were assessed in 18 patients with coronary risk factors on 5 occasions:(1) at location A(576 m),(2) on the first day at moderate altitude(location B, 1700 m),(3) after 3 weeks at moderate altitude,(4) and(5) again at location A(6 and 1 6 weeks after the stay at moderate altitude, respectively). In addition, markers of lipid metabolism, serum erythropoietin and endothelin were measured. Results : FMD on the first day at moderate altitude was similar compared to baseline FMD at location A(7.0±3.3 vs. 7.4±4.6%; NS). A 3-week stay at moderate altitude was associated with a significant reduction in FMD(7.4±4.6 vs. 3.8±2.5%; p< 0.05) despite a decrease in baseline diameter(4.5±0.3 vs. 4.3±0.4 mm; p< 0.05) . Six weeks after returning to location A, FMD was still reduced compared to bas eline(4.3±2.8%; p< 0.05) and after further 16 weeks, FMD returned to baseline values(5.5±3.5%). However, metabolic parameters improved significantly. In contrast, NMD and endo thelin levels remained unchanged. Conclusion: In patients with metabolic syndrom e, a sojourn of 3 weeks at moderate altitude leads to a prolonged, but reversibl e impairment of FMD. The discrepancy to improvement of other cardiovascular and metabolic parameters requires further investigation.
文摘Background: 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. Methods: 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 nonresponders). Results: 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± 0.6 fmol/ml; p=0.04). By contrast, the latter variables did not change in non-responders. Improvement in functional capacity in responders was associated with an increase in FMD(8.2± 3.9% to 11.0± 5.6% ; p< 0.05). Increments in FMD were directly correlated with increases in walking distance(r=0.34; p< 0.05). Conclusion: Short-term improvement of submaximal exercise capacity in CHF patients following optimized therapy with ACE inhibitors and beta blockers is associated with restoration of endothelial function in conduit arteries.
