Key result
Chronic HF exhibits impaired vascular function and higher resting pulse wave velocity versus controls.
Why the study?
Vascular remodelling of large arteries increases left ventricular afterload, but whether vascular remodelling and function under laboratory and 24-hour ambulatory conditions are impaired in chronic heart failure independently of cardiovascular risk factors was unclear.
Cross-Sectional (n=223)
No
Patients with chronic heart failure exhibit augmented vascular remodeling and functional impairment independent of traditional cardiovascular risk factors, which correlates with disease severity.
Vascular impairment may refine chronic HF phenotyping; supports hypothesis-generating research on remodeling independent of risk factors.
BACKGROUND: Vascular remodelling of large arteries increases afterload of the left ventricle. The aim of this study was to analyse whether vascular remodelling and function under laboratory and 24-hour ambulatory conditions is impaired in patients with chronic heart failure (CHF) independently of cardiovascular risk factors. METHODS AND RESULTS: In this monocentric cross-sectional observational study, 105 patients with CHF and an ejection fraction ≤49% (CHF+) were compared to 118 subjects without CHF (CHF-). After adjustment for age, gender, arterial hypertension, hyperlipidaemia, type 2 diabetes, obesity and smoking, vascular function and structure parameters, as assessed by pulse wave analysis (SphygmoCor) and the UNEX EF device, respectively, between the CHF+ and the CHF- group differed for resting pulse wave velocity (PWV) (P = 0.010), 24-h ambulatory PWV (P = 0.011), central systolic blood pressure (cSBP) (P = <0.001), 24-h ambulatory cSBP (P = <0.001), resting central augmentation index (P = 0.002), and brachial intima-media thickness (P = 0.022). In CHF+ patients, higher levels of NT-proBNP, taken as a marker for the severity of CHF, were related to a higher PWV (r = 0.340, P = <0.001), a higher cSBP (r = 0.292, P = 0.005), and a trend to higher central pulse pressure (cPP) (r = 0.198, P = 0.058), higher 24-h brachial PP (r = 0.322, P = 0.002), and 24-h total peripheral resistance (s = 0.227, P = 0.041) after full adjustment for covariates. CONCLUSIONS: In CHF+ patients we observed augmented vascular remodelling and functional impairment compared with CHF- patients independently of cardiovascular risk factors, age, and gender, and the extent of vascular remodelling and impairment was related to the severity of CHF.
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Pietschner et al. (2022) conducted a cross-sectional in Chronic heart failure (CHF) (n=223). Chronic heart failure vs. Subjects without CHF was evaluated on Vascular function and structure parameters (e.g., resting pulse wave velocity) (p=0.010). Patients with chronic heart failure had significantly impaired vascular function and structure compared to controls, including higher resting pulse wave velocity (P=0.010).
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