P4.10 EFFECT OF SHORT-TERM PERINDOPRIL THERAPY ON ARTERIAL STIFFNESS AND ENDOTHELIAL FUNCTION IN DIASTOLIC HEART FAILURE PATIENTS

Abstract

Background: Vascular load is an important determinant of ventricular function. Understanding the physiologic basis of vascular load is central to the development of new strategies and drugs to treat HF. Aim: to evaluate arterial stiffness, endothelial function, clinical status at baseline and in 6 months follow-up period of perindopril therapy in diastolic HF. Methods: 40 patients with exertional dyspnea, I-II NYHA, EF>45%, aged 62(8,4) years, F/M=27/13, history of CHF 29(16) months, BMI 29,4kg/m2. Arterial stiffness was assessed by measuring carotid-femoral PWV and central: mean BP(MAP), pulse pressure(CPP), AIX using applanation tonometry (Sphygmocor) at the baseline and in 6-months f-up. Endothelial dysfunction using FMD during reactive hyperemia (HDI 5000), clinical status with MQLHF were assessed at the baseline and in 6-months f-up period. All patients were on perindopril therapy, mean dose 8mg/day. Results: Baseline 6months f-up p PWV 10(8,6;11,9) 9(8,3;11,5) =0.06 CSBP 135(123;152) 132(124;140) ns CDBP 85(79;93) 82(80,5;90) ns SBP 145(134;154) 131(126;142) <0.05 DBP 85(80;91) 80(76;86) ns CPP 52(41,5;59) 44(42;52) ns MAP 105,5(97,5;115,5) 104(98;110) ns AIX 32,5(27,5;41.5) 38(30,38) ns FMD 5,6(3;6,5) 6,5(3,3;7,1) <0.05 NYHA FC 2(1;2) 1(1;2) <0.05 MQL 39,5(27;48) 33,5(25;41) ns Conclusions: The present study demonstrates that short-term perindopril therapy improved endothelial function, led to favourable trends with regard to the reduction of arterial stiffness and resulted in improvement of NYHA functional class in diastolic heart failure patients, that suggests that perindopril is therapeutically usefull in the therapy of diastolic HF.