P7.12 ARTERIAL STIFFNESS IN PATIENTS WITH HEART FAILURE OF ISCHEMIC AND NON-ISCHEMIC AETIOLOGY

Abstract

Increased arterial stiffness abnormal ventricular-vascular coupling have increasingly been recognized as playing an important pathophysiologic role in HF, both systolic and with normal ejection fraction. Aim: to assess and compare arterial stiffness, central blood pressure parameters in systolic heart failure patients with ischemic and non-ischemic aetiology. Methods: 2 groups of patients with systolic (EF<40%) congestive heart failure (CHF) I-IV functional classes NYHA were enrolled in the study: 1) ischemic aetiology group was respresented by 60 patients with ischemic heart disease: Age, years 59(10), BMI (kg/m2) 28,41, CHF 36(10,4) months, FC NYHA 8(12%)/33(55%)/11(27%)/3(6%); EF 33,3%; 100%sinus rhythm; SBP 124(17,3)mmHg, DBP 77,3(9,5)mmHg; therapy: diuretics 42(76%), BB/ACEi 100%. 2) non-ischemic aetiology group - 15 patients with dilated cardiomyopathy: Age, years 42,2 (9,4), BMI (kg/m2) 28,5, CHF 38(7,2) months, FC NYHA 4(26%)/6(42%)/4(26%)/1(6%); EF 28,2%; 100%sinus rhythm; SBP 119(9,24)mmHg, DBP 77,5(8,1)mmHg, therapy: diuretic 12(80%), BB/ACEi 100%. Carotid-femoral pulse wave velocity (c-f PWV) was measured as index of arterial stiffness, central blood pressure parameters: mean arterial pressure, pulse pressure, aortic augmentation index, using applanation tonometry (Sphygmocor). Results:C-f PWV was lower in non-ischemic group compared with ischemic group (6,8(6,4;7,8) vs. 9,0(7,5;10,0) m/sec;p<0.005). Central BP parameters (MAP,CPP,AIX) didn’t differ between 2 selected groups (p>0.05). Conclusions: Arterial stiffness is increased in patients with ischemic systolic CHF comparing with non-ischemic systolic CHF, that may suggest that arterial stiffness is implicated in the complex of pathophysiology of CHF. The behavior of central blood pressure gemodynamics is common both in ischemic and non-ischemic aetiology groups.