Combined Ventricular Systolic and Arterial Stiffening in Patients With Heart Failure and Preserved Ejection Fraction. Implications for Systolic and Diastolic Reserve Limitations

TLDR: Patients with HF-lnEF have systolic-ventricular and arterial stiffening beyond that associated with aging and/or hypertension, which may play an important pathophysiological role by exacerbating systemic load interaction with diastolic function, augmenting blood pressure lability, and elevating cardiac metabolic demand under stress.

Abstract: Background Heart failure with preserved ejection fraction (HF-nlEF) is common in aged individuals with systolic hypertension and is frequently ascribed to diastolic dysfunction We hypothesized that such patients also display combined ventricular-systolic and arterial stiffening that can exacerbate blood pressure lability and diastolic dysfunction under stress Methods and results Left ventricular pressure-volume relations were measured in patients with HF-nlEF (n=10) and contrasted with asymptomatic age-matched (n=9) and young (n=14) normotensives and age- and blood pressure-matched controls (n=25) End-systolic elastance (stiffness) was higher in patients with HF-nlEF (47+/-15 mm Hg/mL) than in controls (21+/-09 mm Hg/mL for normotensives and 33+/-10 mm Hg/mL for hypertensives; P Conclusion Patients with HF-lnEF have systolic-ventricular and arterial stiffening beyond that associated with aging and/or hypertension This may play an important pathophysiological role by exacerbating systemic load interaction with diastolic function, augmenting blood pressure lability, and elevating cardiac metabolic demand under stress