PERIPHERAL ARTERY STRUCTURE AND ENDOTHELIAL FUNCTION IN HEART-FAILURE- EFFECT OF ACE-INHIBITION

Chronic heart failure (CHF) induces peripheral vasoconstriction and im pairs endothelium-dependent relaxation of large arteries. We investiga ted in a rat model of CHF (coronary artery ligation) I)whether endothe lial dysfunction also exists in resistance arteries, 2) whether this i s associated with vascular morphological changes, and 3) the effect of angiotensin-converting enzyme (ACE) inhibition on these parameters. A fter 1 mo or 1 yr, CHF reduced the vasodilatory response to acetylchol ine of isolated, perfused femoral and mesenteric artery segments. This impairment was more marked in femoral than in mesenteric arteries. Ho wever, CHF did not induce any arterial remodeling. Chronic treatment w ith the ACE inhibitor perindopril improved the response to acetylcholi ne and reduced media cross-sectional area and collagen density. Thus a t the level of small peripheral arteries, CHF induces an endothelial d ysfunction but does not affect vascular structure. ACE inhibition prev ents the CHF-induced endothelial dysfunction and induces vascular remo deling. These changes could contribute to the observed beneficial effe cts of ACE inhibitors on hemodynamics and survival in CHF.