J Korean Med Sci.  2024 Jun;39(23):e195. 10.3346/jkms.2024.39.e195.

Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

• Kim HL
• Jo SH

• KMID: 2556684
• DOI: http://doi.org/10.3346/jkms.2024.39.e195

Abstract

Heart failure with preserved ejection fraction (HFpEF) is prevalent and associated with a poor prognosis, imposing a significant burden on society. Arterial stiffness is increasingly recognized as a crucial factor in the pathophysiology of HFpEF, affecting diagnosis, management, and prognosis. As a hallmark of vascular aging, arterial stiffness contributes to increased afterload on the left ventricle (LV), leading to diastolic dysfunction, a key feature of HFpEF. Elevated arterial stiffness is linked with common cardiovascular risk factors in HFpEF, such as hypertension, diabetes and obesity, exacerbating the progression of disease. Studies have demonstrated that patients with HFpEF exhibit significantly higher levels of arterial stiffness compared to those without HFpEF, highlighting the value of arterial stiffness measurements as both diagnostic and prognostic tools. Moreover, interventions aimed at reducing arterial stiffness, whether through pharmacological therapies or lifestyle modifications, have shown potential in improving LV diastolic function and patient outcomes. Despite these advancements, the precise mechanisms by which arterial stiffness contributes to HFpEF are still not fully understood, necessitating the need for further research.

Keyword

Heart Failure; Diastolic; Pulse Wave Analysis; Vascular Stiffness

Figure

• 

  Fig. 1 Underlying pathophysiology of the association between increased arterial stiffness and HFpEF.SBP = systolic blood pressure, PP = pulse pressure, LVH = left ventricular hypertrophy, DBP = diastolic blood pressure, LV = left ventricular, HFpEF = heart failure with preserved ejection fraction.

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