Effects of spironolactone on ventricular-arterial coupling in patients with chronic systolic heart failure and mild symptoms.

Background: Several studies demonstrated that mineralocorticoid receptor antagonists (MRAs) are able to prevent myocardial and vascular fibrosis, and left ventricular (LV) remodeling in patients with systolic chronic heart failure (HF) and mild symptoms. Ventricular-arterial coupling (VAC) should be influenced by anti-fibrotic interventions. We have assessed the effects of spironolactone on VAC and its components, aortic elastance (Ea) and end-systolic LV elastance (Ees), in patients with HF.

Increased proximal arterial stiffness and cardiac response with moderate exercise in patients with heart failure and preserved ejection fraction.

Objectives: This study sought to demonstrate that arterial stiffness is probably underestimated in patients with heart failure with preserved ejection fraction (HFpEF) at rest and may be revealed with moderate exercise.

Background: HFpEF is associated with ventriculoarterial stiffening.

Methods: We compared 23 patients with stable chronic HFpEF, left ventricular ejection fraction >45%, and impaired relaxation with 15 controls without cardiac disease.

Noninvasively determined radial dP/dt is a predictor of mortality in patients with heart failure.

Background: The left ventricular (LV) developed pressure is a marker of contractility, associated with a poor prognosis during systolic heart failure. The maximal first derivative or slope of the radial pulse wave (Rad dP/dt) has been proposed as a marker of LV systolic function. This study sought to assess the prognostic value of the baseline dP/dt of the radial pulse in patients with heart failure.

Colour tissue Doppler underestimates myocardial velocity as compared to spectral tissue Doppler: poor reliability between both methods.

Aims: Since colour tissue Doppler (CTD) has been shown to underestimate myocardial velocity, we sought to compare CTD with spectral tissue Doppler (STD) and establish agreement and corresponding thresholds for clinical applications.

Methods And Results: We included 52 consecutive patients with sinus rhythm referred for echocardiographic assessment. Analysis involved a commercially available echosonographer (Vivid 7, GE-Vingmed) and the Echopac system for offline assessment.