CHARACTERISTICS OF THE DAILY PROFILE OF ARTERIAL STIFFNESS IN PATIENTS WITH CHRONIC HEART FAILURE

Objective: Arterial stiffness (AS) is a significant prognostic factor in cardiovascular diseases. The significance of AS parameters in HF is not completely clear. The aim of the study was to characterize the AS parameters measured once and within 24 h in patients with HF. Design and method: 24-h evaluation of BP and AS was performed in 67 patients with chronic HF and a history of hypertension (62.7% men, 71.1±10.7 years) (BPLab Vasotens), cognitive function (CF) was assessed by MOCA test, score <26 was considered as a decrease. Severity of congestion was assessed by lung ultrasound, liver fibroelastometry, bioimpedance vector analysis (BIVA). The thresholds of increased AS were central pulse pressure (CPP) >=50 mmHg, carotid-femoral pulse wave velocity (cfPWV) >10 m/s and its deviation from the individual reference value. We analyzed subgroups with EF <40% (reduced, rEF, 40,3%) and >=50% (preserved, pEF, 59,7%). The results were considered statistically significant at p <0.05 (Table 1).Results: The most frequent marker of increased AS was the elevation of cfPWV >10 m/s (rEF 63%; pEF 45-53%). Despite similar 24 h profiles of peripheral and central BP, patients with HFrEF compared to HFpEF had higher frequency of cfPWV elevation above ind ref values (61.5% vs 33.3% (p=0.025) for 24 h;59.3% vs 33.3% (p=0.037) at day;66.7% vs 35.9% (p=0.014) at night) and lower frequency of CPP increase (7.4% vs 33.3%, p=0.017; 3.7% vs 33.3%, p=0.005 and 11.1% vs 43.6%, p=0.005, respectively). An increase in cfPWV >10 m/s was associated with higher liver density (p=0.017) and albuminuria (p=0.041). Patients with increased cfPWV and CPP were characterized by a worse MOCA score: 18 [17; 21] versus 23 [19; 26] (p=0.007), 18 [13.5; 21] versus 20 [18; 25] (p=0.045). The history of iSGLT2 intake before hospitalization was associated with lower cfPWV: 5.9 [4.3; 7.5] versus 11.2 [8.4; 13.9] m/s, p=0.031. Conclusions: Patients with HFrEF compared with HFpEF are characterized by more frequent increases in 24-h cfPWV. Increased AS is associated with higher liver density and albuminuria and lower CF. Use of SGLT2 inhibitors was associated with lower AS values.