2012
DOI: 10.1016/j.jacc.2011.11.082
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Endothelial Dysfunction, Arterial Stiffness, and Heart Failure

Abstract: Outcomes for heart failure (HF) patients remain suboptimal. No known therapy improves mortality in acute HF and HF with preserved ejection fraction; the most recent HF trial results have been negative or neutral. Improvement in surrogate markers has not necessarily translated into better outcomes. To translate breakthroughs with potential therapies into clinical benefit, a better understanding of the pathophysiology establishing the foundation of benefit is necessary. Vascular function plays a central role in … Show more

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Cited by 384 publications
(303 citation statements)
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“…Histopathologic analyses have revealed a greater prevalence of replacement fibrosis and a lesser degree of myocardial hypertrophy in patients with ICM compared to DCM 13. The mechanisms by which MSCs may have improved cardiac function in patients with DCM include the restoration of endothelial function, which enhances coronary circulation,6, 38 and the reduction of fibrosis and tumor necrosis factor–α, an inflammatory biomarker associated with worsening HF and contractility 39, 40. Those with ICM likely benefit mostly from the stem cells’ antifibrotic properties through reduction in scar size and subsequent reverse remodeling as indicated by a reduction in SI and ESV 7, 29.…”
Section: Discussionmentioning
confidence: 99%
“…Histopathologic analyses have revealed a greater prevalence of replacement fibrosis and a lesser degree of myocardial hypertrophy in patients with ICM compared to DCM 13. The mechanisms by which MSCs may have improved cardiac function in patients with DCM include the restoration of endothelial function, which enhances coronary circulation,6, 38 and the reduction of fibrosis and tumor necrosis factor–α, an inflammatory biomarker associated with worsening HF and contractility 39, 40. Those with ICM likely benefit mostly from the stem cells’ antifibrotic properties through reduction in scar size and subsequent reverse remodeling as indicated by a reduction in SI and ESV 7, 29.…”
Section: Discussionmentioning
confidence: 99%
“…The major effect of age on the vasculature is systolic hypertension with widening of the pulse pressure that results from age‐related increase in arterial stiffness and early wave reflections 43, 44. Arterial stiffening and early wave reflections are steady vascular features in HFpEF 45, 46, 47, 48, 49, 50, 51, 52. In the proximal arterial tree, vascular smooth cell loss of elastin increases systolic arterial pressure by lessening the “windkessel” effect 44, 45, 53.…”
Section: Aging Phenotypementioning
confidence: 99%
“…The proinflammatory cytokines involved in HF promote myocardial damage and other pathogenic manifestations through an array of mechanisms, including, for example, increased arterial stiffness and endothelial dysfunction 13, 14, 15, 16, 17, 18, 19…”
Section: Introductionmentioning
confidence: 99%