Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 60, Issue 16, Pages 1455-1469Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2011.11.082
Keywords
arterial stiffness; endothelial function; heart failure
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Outcomes for heart failure (HF) patients remain suboptimal. No known therapy improves mortality in acute HF and HF with preserved ejection fraction; the most recent HF trial results have been negative or neutral. Improvement in surrogate markers has not necessarily translated into better outcomes. To translate breakthroughs with potential therapies into clinical benefit, a better understanding of the pathophysiology establishing the foundation of benefit is necessary. Vascular function plays a central role in the development and progression of HF. Endothelial function and nitric oxide availability affect myocardial function, systemic and pulmonary hemodynamics, and coronary and renal circulation. Arterial stiffness modulates ventricular loading conditions and diastolic function, key components of HF with preserved ejection. Endothelial function and arterial stiffness may therefore serve as important physiological targets for new HF therapies and facilitate patient selection for improved application of existing agents. (J Am Coll Cardiol 2012;60:1455-69) (c) 2012 by the American College of Cardiology Foundation
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