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The European Society of Cardiology

Arterial stiffness in heart failure patients: dependance on diastolic dysfunction and plasma aldosterone levels

Cristina Giannattasioa,d, Felice Achillib, Monica Faillaa, Anna Capraa, Antonella Vincenzib, Gaetano Gentilea, Davide Corsia, Chiara Zazzerona, Lucia Turoloc, Alberto Morgantic and Giuseppe Manciaa,c,d,*

a Clinica Medica, Dipartimento di Medicina, Clinica Prevenzione e Biotecnologie Sanitarie, Università  di Milano-Bicocca, Milano, Italy
b Divisione di Cardiologia, Ospedale S. Gerardo di Monza, Milano, Italy
c Istituto Interuniversitario Fisiologia Clinica e Ipertensione, Policlinico di Milano-Pavia-Monza, Milano, Italy
d IRCCS Istituto Auxologico, Milano, Italy

* Correspondence: Giuseppe Mancia, Medicina Interna I , Ospedale San Gerardo, Via Donizetti 106, 20052, Monza (MI), Italy. Tel.: +39 2333357; fax: +39 322274 (E-mail: giuseppe.mancia{at}unimib.it).

Abstract

BACKGROUND: Heart failure is accompanied by large artery wall stiffening. Aim of the present study was to see whether the stiffening correlates (1) with the severity of the disease, (2) with the concomitant diastolic dysfunction and (3) with plasma aldosterone concentration, i.e. the concentration of a substance stimulating vessel fibrosis.

PATIENTS AND METHODS: We measured diameter (D) and distensibility (Dist) of a common carotid artery (CA) and abdominal aorta (AO) by an echotracking technique in 34 patients with mild to moderate congestive heart failure under diuretic, digitalis and ace-inhibitors treatment.

RESULTS: AO Dist correlated with the E/A or Dec time obtained by an echocolordoppler examination (r 0.62 and – 0.42, respectively, p<0.02) while showing an inverse relationship with the VO2 max obtained by cardiopulmonary stress test (r –0.47, p<0.01) and with the plasma concentration of aldosterone (r 0.39, p<0.04). Similar findings were obtained for CA Dist.

CONCLUSIONS: Thus the arterial stiffening increases with the heart failure severity and shows a parallelism with the reduced ability of the heart to relax in response to transmural pressure. The increased plasma levels of aldosterone (even in patients under ace-inhibitor) may play a role in this alteration of arterial mechanical properties.

Keywords Arterial stiffness; Diastolic dysfunction; Plasma aldosterone; Vessel fibrosis


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