Heart Failure With Preserved Ejection Fraction
Conditions
Keywords
heart failure, preserved ejection fraction, vascular stiffness
Brief summary
This study will test the hypothesis that increases in ventricular-vascular stiffness can be demonstrated by arterial tonometry and echocardiography in subjects with heart failure with preserved ejection fraction (HF-nlEF)(i.e. normal left ventricular function.) We will also track changes in pulsatile hemodynamics over time in subjects hospitalized with HF-nlEF.
Detailed description
The pathophysiologic mechanisms responsible for the development of heart failure in people with preserved ejection fraction (i.e. normal left ventricular function) remain poorly understood. One possible mechanism may be the contribution of increased arterial stiffness to changes in pulsatile hemodynamic load during ventricular systole, implicating abnormal ventricular-vascular interactions throughout the cardiac cycle in the pathogenesis of heart failure with normal ejection fraction. To investigate changes in ventricular-vascular stiffness in subjects with heart failure and normal left ventricular function, comparisons will be made between 3 distinct sub-populations: * subjects with heart failure and normal ejection fraction * non-diabetic hypertensive controls * normotensive controls
Interventions
PROCEDUREarterial tonometry
used to determine peripheral arterial vascular tone by measuring blood pressure waveforms via a probe attached to the finger.
PROCEDUREechocardiography
ultrasound test using sound waves to create a moving picture of the heart
Sponsors
Brigham and Women's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Subjects with heart failure and preserved ejection fraction * clinical signs of heart failure * serum brain natriuretic peptide (BNP) \>100pg/mL * NYHA functional class II-IV * left ventricular ejection fraction(LVEF) \>=50% measured by echocardiography * Non-diabetic subjects with hypertension * treated or untreated essential hypertension * LVEF \>=50% measured by echocardiography Diabetic subjects with hypertension * Type 2 diabetes * treated or untreated essential hypertension * LVEF \>=50% measured by echocardiography Normotensive control subjects * normal blood pressure (i.e. \< 140/90 mmHg) * LVEF \>=50% measured by echocardiography
Exclusion criteria
Subjects with heart failure and preserved ejection fraction * atrial fibrillation * symptoms of angina or a myocardial infarction (MI) within 6 months * known significant coronary artery disease (CAD) (stenosis \> 70%) * significant valvular heart disease * restrictive/constrictive heart disease * inability to lie flat for procedure (estimated duration 1 hour) Non-diabetic subjects with hypertension * atrial fibrillation * symptoms of angina or a myocardial infarction (MI) within 6 months * known significant coronary artery disease (CAD) (stenosis \> 70%) * significant valvular heart disease * restrictive/constrictive heart disease * inability to lie flat for procedure (estimated duration 1 hour) * prior history of heart failure or unexplained dyspnea Diabetic subjects with hypertension * atrial fibrillation * symptoms of angina or a myocardial infarction (MI) within 6 months * known significant coronary artery disease (CAD) (stenosis \> 70%) * significant valvular heart disease * restrictive/constrictive heart disease * inability to lie flat for procedure (estimated duration 1 hour) * prior history of heart failure or unexplained dyspnea Normotensive control subjects * prior history of structural heart disease or ventricular hypertrophy * treatment with HMG-Co(A)reductase inhibitors (statins) * anti-hypertensive medications * cigarette smoking * cocaine use * excessive alcohol intake
Countries
United States
Outcome results
None listed