Peripheral endothelial dysfunction is a novel risk factor for systolic dysfunction and heart failure progression.

Area of Science:

• Cardiology
• Vascular Medicine
• Preventive Cardiology

Background:

• Heart failure (HF) progresses through stages, from risk factors (Stage A) to asymptomatic dysfunction (Stage B) and symptomatic disease (Stage C).
• Peripheral endothelial dysfunction (PED) predicts adverse outcomes in symptomatic HF (Stage C).
• Interventions targeting earlier stages of HF may prevent symptomatic progression.

Purpose of the Study:

• To investigate the association between peripheral endothelial dysfunction (PED) and Stage B heart failure (HF).
• To determine if PED is a risk factor for early-stage cardiac dysfunction.

Main Methods:

• Retrospective cross-sectional analysis of 355 patients undergoing cardiovascular evaluation.
• Assessment of peripheral endothelial function using reactive hyperemia-peripheral arterial tonometry.
• Echocardiography performed within 2 months of PED testing; patients with clinical HF were excluded.

Main Results:

• A significant association was found between PED and Stage B HF (OR 6.38, P < 0.0001).
• This association remained significant after multivariate analysis (OR 5.33, P = 0.0038).
• PED was also associated with progression to symptomatic Stage C HF (OR 4.63, P = 0.033).

Conclusions:

• Peripheral endothelial dysfunction is a risk factor for Stage B heart failure, even in individuals considered low risk.
• Further research is needed to elucidate the mechanisms of PED in HF.
• Understanding these mechanisms could lead to strategies for reducing the risk of symptomatic HF progression.