Abstract
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. 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. 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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