Arterial stiffness in heart failure patients: Dependance on diastolic dysfunction and plasma aldosterone levels

Heart failure is accompanied by large artery wall stiffening. Aim of the present study was to see whether the stiffening correlates (1) with the severity of the disease, (2) with the concomitant diastolic dysfunction and (3) with plasma aldosterone concentration, i.e. the concentration of a substance stimulating vessel fibrosis. We measured diameter (D) and distensibility (Dist) of a common carotid artery (CA) and abdominal aorta (AO) by an echotracking technique in 34 patients with mild to moderate congestive heart failure under diuretic, digitalis and ace-inhibitors treatment. AO Dist correlated with the E/A or Dec time obtained by an echocolordoppler examination (r 0.62 and - 0.42, respectively, p <0.02) while showing an inverse relationship with the VO ₂ max obtained by cardiopulmonary stress test (r -0.47, p <0.01) and with the plasma concentration of aldosterone (r 0.39, p <0.04). Similar findings were obtained for CA Dist. Thus the arterial stiffening increases with the heart failure severity and shows a parallelism with the reduced ability of the heart to relax in response to transmural pressure. The increased plasma levels of aldosterone (even in patients under ace-inhibitor) may play a role in this alteration of arterial mechanical properties.