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J Am Coll Cardiol, 2005; 46:1011-1018, doi:10.1016/j.jacc.2005.04.060 (Published online 20 September 2005).
© 2005 by the American College of Cardiology Foundation
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Flow-Mediated Vasodilation Predicts Outcome in Patients With Chronic Heart Failure

Comparison With B-Type Natriuretic Peptide

Brigitte Meyer, MD, Deddo Mörtl, MD, Karin Strecker, MD, Martin Hülsmann, MD, Vanessa Kulemann, MD, Thomas Neunteufl, MD, Richard Pacher, MD and Rudolf Berger, MD*

Department of Cardiology, Medical University of Vienna, Vienna, Austria.



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  		Figure 1 The mean endothelium-dependent flow-mediated vasodilation (FMD) of event-free survivors (open bars) compared with patients who converted to United Network for Organ Sharing status 1 or died (solid bars) in all chronic heart failure patients and in the subgroups of patients with dilated cardiomyopathy (DCMP) and ischemic cardiomyopathy (ICMP).

 


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  		Figure 2 The mean endothelium-dependent flow-mediated vasodilation (FMD) of 10 patients in New York Heart Association (NYHA) functional class I, 17 in class II, 39 in class III, and 9 in class IV .

 


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  		Figure 3 The receiver-operating characteristic curve illustrates the sensitivity and specificity of endothelium-dependent flow-mediated vasodilation (FMD) in discriminating patients who reached the combined end point from survivors (FMD 6.8%; sensitivity 63%, specificity 67%). The area under the curve (AUC) was 0.76.

 


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  		Figure 4 Kaplan-Meier analysis showing cumulative rates of event-free survival in 75 patients with chronic heart failure stratified into two groups according to the median of endothelium-dependent flow-mediated vasodilation (FMD). Patients with FMD >6.8% had a significantly better event-free survival compared with patients with FMD <6.8% (p = 0.004).

 


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  		Figure 5 Kaplan-Meier analysis showing cumulative rates of event-free survival in 75 patients with chronic heart failure stratified into four groups according to their endothelium-dependent flow-mediated vasodilation (FMD) and B-type natriuretic peptide (BNP) levels—group A: FMD >6.8%, BNP <208 pg/ml; group B: FMD <6.8%, BNP <208 pg/ml; group C: FMD >6.8%, BNP >208 pg/ml; and group D: FMD <6.8%, BNP >208 pg/ml.

 




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