The following is a summary of “Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study,” published in the March 2024 issue of Cardiology by Rezaeian et al.
Heart failure with preserved ejection fraction (HFpEF) is one of the most common complications in patients suffering with cardiac problems, which often carries itself along with coronary microvascular dysfunction (CMD), yet conclusive pathways remain unclear.
Researchers conducted a prospective study evaluating the role of Aortic pulse-wave velocity (aPWV) in CMD and HFpEF, which may provide a better understanding of disease progression.
They included 51 women with suspected CMD and 20 people with evidence of HFpEF who underwent an aPWV measurement with higher aPWV indicating greater vascular stiffness. Cardigan magnetic resonance imaging (CMRI) assessed left ventricular ejection fraction (LVEF), CMD via myocardial perfusion reserve index (MPRI), and ventricular remodeling evaluating left ventricular (LV) mass-volume ratio. Wilcoxon rank sum tests, Pearson correlations, and linear regression analysis were also performed to determine statistical analysis.
The results showed that the HFpEF participants were slightly older than the suspected CMD group (65±12 vs. 56±11 years, P=0.002) with higher BMI (31.0±4.3 vs 27.8±6.7kg/m2, P=0.013), higher aPWV (10.5±2.0 vs 8.0±1.6m/s, P=0.05) and lower MPRI (1.5±0.3 vs 1.8±0.3, P=0.02). However, in a model adjusted for cardiovascular risk factors, the HFpEF group had a lower LVEF ( estimate -4.78, P=0.0437).
Investigators concluded that HFpEF participants had stiffer arteries, reduced heart blood flow, and lower left ventricular ejection fraction (LVEF) compared to suspected CMD participants, hinting that arterial stiffness could worsen CMD into HFpEF.
Source: sciencedirect.com/science/article/pii/S2666602224000338
