Ventricular-Vascular Coupling in Heart Failure

Study Overview
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Brief Summary
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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
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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

Official Title
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Ventricular-Vascular Coupling in Patients With Heart Failure and Preserved Ejection Fraction

Conditions
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Heart Failure With Preserved Ejection Fraction

Intervention / Treatment
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* Procedure: arterial tonometry
* Procedure: echocardiography


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 3<br>subjects with heart failure and normal ejection fraction non-diabetic hypertensive controls hypertensive diabetic controls normotensive controls | Procedure: arterial tonometry<br>* used to determine peripheral arterial vascular tone by measuring blood pressure waveforms via a probe attached to the finger.<br>* Other names: PAT;Procedure: echocardiography<br>* ultrasound test using sound waves to create a moving picture of the heart<br>* Other names: cardiac echo;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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heart failure, preserved ejection fraction, vascular stiffness