Older patients with HFpEF had reduced carotid arterial distensibility compared with older healthy subjects (0.97 vs 1.33 ×10⁻³ mm Hg⁻¹; P=0.008), which correlated with exercise intolerance.
Observational (n=131)
Carotid arterial stiffness is increased in older patients with HFpEF beyond normal aging and correlates with severe exercise intolerance, suggesting it as a potential therapeutic target.
Absolute Event Rate: 0.97% vs 1.33%
p-value: p=0.008
Heart failure with a preserved ejection fraction (HFpEF) is the dominant form of heart failure in the older population. The primary chronic symptom in HFpEF is severe exercise intolerance; however, its pathophysiology and therapy are not well understood. We tested the hypothesis that older patients with HFpEF have increased arterial stiffness beyond what occurs with normal aging and that this contributes to their severe exercise intolerance. Sixty-nine patients ≥60 years of age with HFpEF and 62 healthy volunteers (24 young healthy subjects ≤30 years and 38 older healthy subjects ≥60 years old) were examined. Carotid arterial stiffness was assessed using high-resolution ultrasound, and peak exercise oxygen consumption was measured using expired gas analysis. Peak exercise oxygen consumption was severely reduced in the HFpEF patients compared with older healthy subjects (14.1±2.9 versus 19.7±3.7 mL/kg per minute; P<0.001) and in both was reduced compared with young healthy subjects (32.0±7.2 mL/kg per minute; both P<0.001). In HFpEF compared with older healthy subjects, carotid arterial distensibility was reduced (0.97±0.45 versus 1.33±0.55×10(-3) mm Hg(-1); P=0.008) and Young's elastic modulus was increased (1320±884 versus 925±530 kPa; P<0.02). Carotid arterial distensibility was directly (0.28; P=0.02) and Young's elastic modulus was inversely (-0.32; P=0.01) related to peak exercise oxygen consumption. Carotid arterial distensibility is decreased in HFpEF beyond the changes attributed to normal aging and is related to peak exercise oxygen consumption. This supports the hypothesis that increased arterial stiffness contributes to exercise intolerance in HFpEF and is a potential therapeutic target.
Kitzman et al. (Wed,) conducted a observational in Heart failure with preserved ejection fraction (HFpEF) (n=131). Heart failure with preserved ejection fraction (HFpEF) vs. Older healthy subjects was evaluated on Carotid arterial distensibility (×10⁻³ mm Hg⁻¹) (p=0.008). Older patients with HFpEF had reduced carotid arterial distensibility compared with older healthy subjects (0.97 vs 1.33 ×10⁻³ mm Hg⁻¹; P=0.008), which correlated with exercise intolerance.
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