The Application of Vascular Function Tests for the Primary and Secondary Preventions of Heart Failure

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Arterial stiffness and central hemodynamics are known to be independent risk markers for cardiovascular disease. Then, we examined the applicability of these markers for the management of heart failure (HF). Brachial-ankle pulse wave velocity (baPWV), the radial augmentation index (rAI), the first and second peaks of the radial systolic pressure (SBP1 and SBP2) and PP2 (SBP2 minus diastolic pressure) were measured in 60 patients hospitalized with left ventricle ejection fraction (LVEF) !40%. Up to five year follow-up, none of these markers could predict the re-admission for exacerbation of HF. On the other hand, in 2654 men without cardiovascular disease, PP2, a marker of central pulse pressure, showed a significant odds ratio for new elevation of serum N-terminal fragment B-type natriuretic peptide (NT-proBNP) levels. Thus, central pulse pressure seems to be a useful marker for the primary prevention of subclinical HF, although arterial stiffness and pressure wave analysis are limited to be markers for the secondary prevention of HF.

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