Arterial stiffness and its associations with left ventricular diastolic function according to heart failure types

Abstract

Background Little is known about the characteristics of arterial stiffness in heart failure (HF). This study was performed to compare the degree of arterial stiffness and its association with left ventricular (LV) diastolic function among three groups: control subjects, patients with HF with reduced ejection fraction (HFrEF), and patients with HF with preserved ejection fraction (HFpEF). Methods A total of 83 patients with HFrEF, 68 patients with HFpEF, and 84 control subjects were analyzed. All HF patients had a history of hospitalization for HF treatment. Brachial-ankle pulse wave velocity (baPWV) measurement and transthoracic echocardiography were performed at the same day in a stable condition. Results The baPWV was significantly higher in patients with both HFrEF and HFpEF compared to control subjects (1,661 ± 390, 1,909 ± 466, and 1,477 ± 296 cm/sec, respectively; P < 0.05 for each). After adjustment of age, baPWV values were similar between patients with HFrEF and HFpEF (P = 0.948). In the multiple linear regression analysis, baPWV was significantly associated with both septal e′ velocity (β = –0.360, P = 0.001) and E/e′ (β = 0.344, P = 0.001). However, baPWV was not associated with either of the diastolic indices in HFrEF group. The baPWV was associated only with septal e′ velocity (β = –0.429, P = 0.002) but not with E/e′ in the HFpEF group in the same multivariable analysis. Conclusions Although arterial stiffness was increased, its association with LV diastolic function was attenuated in HF patients compared to control subjects. The degree of arterial stiffening was similar between HFrEF and HFpEF.

Cardiovascular Consequences of Uremic Metabolites: an Overview of the Involved Signaling Pathways

“…226 RAAS involves many aspects of CVD, from ED, inflammation, and oxidative stress in atherosclerosis and hypertension to myocardial remodeling with heart failure development. 227–229 RAAS blockage protects against ED and arrhythmia. 230 In addition to the RAAS, atherosclerosis and VC caused by various uremic metabolites play a role in arterial remodeling and a decrease of elasticity, inducing significantly increased systolic arterial blood pressure.…”

“…230 In addition to the RAAS, atherosclerosis and VC caused by various uremic metabolites play a role in arterial remodeling and a decrease of elasticity, inducing significantly increased systolic arterial blood pressure. 177,229 Moreover, ADMA/SDMA and UA also play an essential role in blood pressure regulation and hypertension development in patients with CKD, owing to their negative effects on bioactive NO elaboration 109,110,123 and consequent impaired vascular relaxation.…”

Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

“… 70 In a study conducted on Koreans by our research team with similar findings, baPWV was significantly increased in HFpEF patients with a history of hospitalization compared to the control group (1,909 vs. 1,661 cm/sec). 71 Reddy et al 72 assessed central aorta compliance by invasively obtaining radial artery waveforms in 98 patients with HFpEF and 22 patients with hypertension. The study findings indicated that HFpEF patients, when compared to hypertensive patients, exhibited reduced arterial compliance, which correlated with increased LV filling pressure.…”

Central blood pressure and arterial stiffness in patients admitted with acute decompensated heart failure

“…Имеются свидетельства вклада повышенной АР в развитие СН de novo [12], низкую переносимость физических нагрузок при СН, ассоциаций повышения каротидно-феморальной скорости распространения пульсовой волны (кфСРПВ) с сердечной недостаточностью с сохранной фракцией выброса (СНсФВ) [13]. В некоторых исследованиях продемонстрировано повышение параметров АР при СН по сравнению с контрольной группой [14], но изменения жесткости при разных фенотипах фракции выброса (ФВ) изучены недостаточно [15,16]. Работ, посвященных изучению взаимного влияния параметров ригидности и диастолической функции и вклада повышенной жесткости в прогноз у пациентов с СНсФВ немало, хотя результаты их 55,5 %, central PP ≥ 50 mmHg -in 16,6 %, high AS gradient -in 70,3 %.…”