arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2024-2386WZYOKLarthyper-2386Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESХарактеристика центрального артериального давления и артериальной ригидности у госпитализированных пациентов с сердечной недостаточностьюCentral blood pressure and arterial stiffness in patients admitted with acute decompensated heart failurehttps://orcid.org/0009-0004-0416-2864ЗенкинаА. Н.ZenkinaA. N.

Зенкина Анна Николаевна — аспирант кафедры внутренних болезней с курсом кардиологии и функциональной диагностики имени академика В.С. Моисеева

ул. Вавилова, д.61, Москва, 117292

Anna N. Zenkina, MD, PhD Student, Department of Internal Medicine with the Course in Cardiology and Functional Diagnostics Named After V. S. Moisseev, Medical Institute

61 Vavilova str., Moscow, 1 17292

asamsonova@inbox.ruhttps://orcid.org/0000-0003-1756-7583ТроицкаяЕ. А.TroitskayaE. A.

Троицкая Елена Алексеевна — кандидат медицинских наук, доцент кафедры внутренних болезней с курсом кардиологии и функциональной диагностики имени академика В.С. Моисеева Медицинского института

Москва

 

Elena A. Troitskaya, MD, PhD, Associate Professor, Department of Internal Medicine with the Course in Cardiology and Functional Diagnostics Named After V. S. Moisseev, Medical Institute

Moscow

troitskaya_ea@rudn.universityhttps://orcid.org/0000-0002-5873-1768КобалаваЖ. Д.KobalavaZ. D.

Кобалава Жанна Давидовна — доктор медицинских наук, профессор, член-корреспондент Российской академии наук, заведующая кафедрой внутренних болезней с курсом кардиологии и функциональной диагностики имени академика В. С. Моисеева Медицинского института

Москва

Zhanna D. Kobalava, MD, PhD, DSc, Professor, Corresponding Member of Russian Academy of Science, Chief, Department of Internal Medicine with the Course in Cardiology and Functional Diagnostics Named AfterV. S. Moisseev, Medical Institute

Moscow

zkobalava@mail.ruhttps://orcid.org/0009-0004-5633-5704АндрееваЕ. А.AndreevaE. A.

Андреева Екатерина Алексеевна — аспирант кафедры внутренних болезней с курсом кардиологии и функциональной диагностики имени академика В.С. Моисеева Медицинского института

Москва

Ekaterina A. Andreeva, MD, PhD Student, Department of Internal Medicine with the Course in Cardiology and Functional Diagnostics Named AfterV. S. Moisseev, Medical Institute

Moscow

katya.andr96@gmail.comФедеральное государственное автономное образовательное учреждение высшего образования «Российский университет дружбы народов имени Патриса Лумумбы»РоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian Federation202426022024301121135Copyright © Зенкина А.Н., Троицкая Е.А., Кобалава Ж.Д., Андреева Е.А., 20242024Зенкина А.Н., Троицкая Е.А., Кобалава Ж.Д., Андреева Е.А.Zenkina A.N., Troitskaya E.A., Kobalava Z.D., Andreeva E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2386

Цель исследования: охарактеризовать изменения центрального артериального давления (цАД) и параметров артериальной ригидности (АР) у пациентов, госпитализированных с СН, в зависимости от фенотипов фракции выброса (ФВ) и изучить их изменения на фоне стабилизации состояния через 6 месяцев. Материалы и методы: у  пациентов, госпитализированных с острой декомпенсацией СН (ОДСН), помимо рутинного обследования, на 3-4-й день госпитализации проводили измерение цАД и параметров АР методом аппланационной тонометии (SphygmoCor). При интерпретации результатов цАД использовали референсные значения для здоровой популяции В качестве маркеров повышения АР рассматривали периферическое пульсовое давление (ПД) ≥60 мм рт.ст., каротидно-феморальную скорость распространения пульсовой волны (кфСРПВ) >10 м/с, отклонение кфСРПВ от индивидуальной нормы и утрату градиента жесткости (ГЖ) (кфСРПВ/каротидно-радиальная (кр)СРПВ ≥1). Анализ проводили в подгруппах с ФВ ≥50% и <50%. Различия считали достоверными при р <0,05. Результаты: 54 пациента (61% мужчин, 69,6±10 лет, медиана ФВ 51% (IQR 38;55%), медиана NTproBNP 623 (500;1842) пг/мл; ХСНнФВ у 37%, ХСНусФВ у 13%, ХСНсФВ у 50%). Исходное периферическое САД в общей группе составило 119,8±17,2 мм рт.ст.; цСАД 109,6±16,9 мм рт.ст. Отсутствие контроля АД выявлено у 40%, гипотония – у 3%. Повышение цСАД в общей группе отмечено у 33% (28,5% при ФВ ≥50% и 38,4% при ФВ <50% (р >0,05)), в т.ч. у 27,1% при клинической нормотонии. Повышение цСАД ассоциировалось с гиперурикемией. Достоверных различий по цСАД и параметрам АР между подгруппами в зависимости от ФВ не выявлено. В целом повышение кфСРПВ >10 м/с выявлено у 48,1%, кфСРПВ выше индивидуальной нормы – у 33,3%, ПД ≥60 мм рт.ст. – у 11,1%, утрата ГЖ – у 70,3%. В группе с нормальной кфСРПВ утрата ГЖ отмечена у 48,1%. Через 6 мес отмечено достоверное повышение цСАД, ПД, кфСРПВ и индекса прироста и снижение амплификации ПД в общей группе. Заключение. У пациентов, госпитализированных с ОДСН, отмечена высокая частота повышения цСАД, независимо от ФВ и контроля периферического АД. Из маркеров АР чаще всего выявлялась утрата ГЖ. Через 6 мес отмечено повышение цСАД и параметров АР.  

Objective. To evaluate central systolic blood pressure (cSBP) and arterial stiffness (AS) in patients admitted with acute decompensated heart failure (ADHF) according to different phenotypes of ejection fraction (EF) and to assess their changes after 6 months of stable guideline-directed medical therapy. Design and methods. In 54 patients (61% males, median age 69,5 (62; 77) years, median EF 51% (interquartile range (IQR) 38; 55%), median N-terminal pro-B-type natriuretic peptide (NTproBNP) 623 (500; 1842) pg/ml; heart failure (HF) with reduced EF in 37%, HF with mildly reduced EF in 13%, HF with preserved EF in 50%), apart from routine tests, we assessed cSBP and AS with applanation tonometry (SphygmoCor). cSBP above individual reference values, central pulse pressure (PP) ≥ 50 mmHg, carotid-femoral pulse wave velocity (cfPWV) > 10 m/s, cfPWV above individual reference values, and aortic-brachial stiffness mismatch (stiffness gradient as cfPWV/carotid-radial (cr)PWV) ≥ 1) were considered abnormal. The statistical analysis was performed in the groups with EF ≥ 50% and < 50% р < 0,05 was considered significant. Results. Brachial systolic blood pressure (bSBP) in the whole group was 117 (106; 130) mmHg; cSBP 109,5 (96; 120) mmHg. Uncontrolled blood pressure was observed in 40%, hypotension — in 3%. There were no differences between groups according to EF. cSBP elevation was observed in 33% (28,5% in EF ≥ 50% and 38,4% in EF < 50%; р > 0,05), and in 27,1% with normal bSBP. There were no significant differences in AS parameters between groups according to EF. Elevation of at least 1 marker of AS was present in 78,5%, cfPWV > 10 ms — in 50%, cfPWV above individual reference values— in 55,5%, central PP ≥ 50 mmHg — in 16,6%, high AS gradient — in 70,3%. Abnormal AS gradient was observed in 48,1% of patients with normal cfPWV. Patients with more severe congestion according to bioimpedance vector analysis (BIVA) had lower cfPWV compared to less severe congestion: 9 (6,7; 10,2) vs 11,6 (6,9; 15,1) m/s, р = 0,04. There was significant correlation between the amount of extracellular fluid by BIVA and cfPWV (r = –0,36, p < 0,05). There was significant increase in cSBP, PP, cfPWV and augmentation index and decrease in PP amplification in the whole group after 6 months. Conclusions. Patients admitted with ADHF have high frequency of cSBP elevation regardless of EF and blood pressure control. The most common marker of AS increase was cfPWV elevation above individual reference values and abnormal stiffness gradient. Patients with less congestion by BIVA had higher cfPWV. After 6 months there was increase in cSBP and parameters of AS.

сердечная недостаточностьдекомпенсация сердечной недостаточностицентральное артериальное давлениеартериальная ригидностьскорость распространения пульсовой волныheart failureacute decompensated heart failurecentral systolic blood pressurearterial stiffnesspulse wave velocityПрограммы стратегического и академического лидерства РУДН. Приоритет 2030.RUDN University Strategic and Academic Leadership Programs. Priority 2030.ReferencesTsao CW, Lyass A, Enserro D, Larson MG, Ho JE, Kizer JR et al. Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction. JACC: Heart Fail. 2018;6(8):678–685. doi:10.1016/j.jchf.2018.03.006Tsao CW, Lyass A, Enserro D, Larson MG, Ho JE, Kizer JR et al. Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction. JACC: Heart Fail. 2018;6(8):678–685. doi:10.1016/j.jchf.2018. 03.006Виноградова Н. Г., Поляков Д. С., Фомин И. В. Анализ смертности у пациентов с ХСН после декомпенсации при длительном наблюдении в условиях специализированной медицинской помощи и в реальной клинической практике. Кардиология. 2020;60(4):91–100. doi:10.18087/cardio.2020.4.n1014.Vinogradova NG, Polyakov DS, Fomin IV. Analysis of mortality in patients with heart failure after decompensation during longterm follow-up in specialized medical care and in real clinical practice. Kardiologiia. 2020;60(4):91–100. doi:10.18087/cardio.2020.4.n1014. In Russian.Shah KS, Xu H, Matsouaka R, Bha DL, Heidenreich PA, Hernandez AF et al. Heart failure with preserved, borderline, and reduced ejection fraction. J Am Coll Cardiol. 2017;70(20):2476– 2486. doi:10.1016/j.jacc.2017.08.074Shah KS, Xu H, Matsouaka R, Bha DL, Heidenreich PA, Hernandez AF et al. Heart failure with preserved, borderline, and reduced ejection fraction. J Am Coll Cardiol. 2017;70(20):2476– 2486. doi:10.1016/j.jacc.2017.08.074Поляков Д.С., Фомин И.В., Беленков Ю.Н., Мареев В.Ю., Агеев Ф. Т., Артемьева Е. Г. и др. Хроническая сердечная недостаточность в Российской Федерации: что изменилось за 20 лет наблюдения? Результаты исследования ЭПОХА-ХСН. Кардиология. 2021;61(4):4–14. doi:10.18087/cardio.2021.4.n1628.Polyakov DS, Fomin IV, Belenkov YuN, Mareev VYu, Ageev FT, Artemyeva EG et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021;61(4):4–14. doi:10.18087/cardio.2021.4.n1628. In Russian.Chi C, Liu Y, Xu Y, Xu D. Association between arterial stiffness and heart failure with preserved ejection fraction. Front Cardiovasc Med. 2021;8:707162. doi:10.3389/fcvm.2021.707162Chi C, Liu Y, Xu Y, Xu D.Association between arterial stiffness and heart failure with preserved ejection fraction. Front Cardiovasc Med. 2021;8:707162. doi:10.3389/fcvm.2021.707162 6. Parragh S, Hametner B, Bachler M, Kellermair J, Eber B, Wassertheurer S et al. Determinants and covariates of central pressures and wave reflections in systolic heart failure. Int J Cardiol. 2015;190:308–314. doi:10.1016/j.ijcard.2015.04.183Parragh S, Hametner B, Bachler M, Kellermair J, Eber B, Wassertheurer S et al. Determinants and covariates of central pressures and wave reflections in systolic heart failure. Int J Cardiol. 2015;190:308–314. doi:10.1016/j.ijcard.2015.04.183Vasan RS, Pan S, XanthakisV, Beiser A, Larson MG, Seshadri S et al. Arterial stiffness and long-term risk of health outcomes: the Framingham heart study. Hypertension. 2022;79(5):1045–1056. doi:10.1161/HYPERTENSIONAHA.121.18776Vasan RS, Pan S, Xanthakis V, Beiser A, Larson MG, Seshadri S et al. Arterial stiffness and long-term risk of health outcomes: the Framingham heart study. Hypertension. 2022;79(5):1045–1056. doi:10.1161/HYPERTENSIONAHA.121.18776Chirinos JA, Kips JG, Jacobs DR Jr, Brumback L, Duprez DA, Kronmal R et al. Arterial wave reflections and incident cardiovascular events and heart failure: MESA (Multiethnic Study of Atherosclerosis). J Am Coll Cardiol. 2012;60(21):2170–2177. doi:10.1016/j.jacc.2012.07.054Chirinos JA, Kips JG, Jacobs DR Jr, Brumback L, Duprez DA, Kronmal R et al. Arterial wave reflections and incident cardiovascular events and heart failure: MESA (Multiethnic Study of Atherosclerosis). J Am Coll Cardiol. 2012;60(21):2170–2177. doi:10.1016/j.jacc.2012.07.054Tsao CW, Lyass A, Larson MG, Levy D, Hamburg NM, Vita JA et al. Relation of central arterial stiffness to incident heart failure in the community. J Am Heart Assoc. 2015;4(11):e002189. doi:10.1161/JAHA.115.002189Tsao CW, Lyass A, Larson MG, Levy D, Hamburg NM, Vita JA et al. Relation of central arterial stiffness to incident heart failure in the community. J Am Heart Assoc. 2015;4(11):e002189. doi:10.1161/JAHA.115.002189Pandey A, Khan H, Newman AB, Lakatta EG, Forman DE, Butler J et al. Arterial stiffness and risk of overall heart failure, heart failure with preserved ejection fraction, and heart failure with reduced ejection fraction: the Health ABC Study (Health, Aging, and Body Composition). Hypertension. 2017;69(2):267–274. doi:10.1161/HYPERTENSIONAHA.116.08327Pandey A, Khan H, Newman AB, Lakatta EG, Forman DE, Butler J et al. Arterial stiffness and risk of overall heart failure, heart failure with preserved ejection fraction, and heart failure with reduced ejection fraction: the Health ABC Study (Health, Aging, and Body Composition). Hypertension. 2017;69(2):267–274. doi:10.1161/HYPERTENSIONAHA.116.08327Dohaei A, Taghavi S, Amin A, Rahimi S, Naderi N. Does aortic pulse wave velocity have any prognostic significance in advanced heart failure patients? J Cardiovasc Thorac Res. 2017;9(1):35–40. doi:10.15171/ jcvtr.2017.05Dohaei A, Taghavi S, Amin A, Rahimi S, Naderi N. Does aortic pulse wave velocity have any prognostic significance in advanced heart failure patients? J Cardiovasc Thorac Res. 2017;9(1):35–40. doi:10.15171/jcvtr.2017.05Zheng H, Wu S, Liu X, Qiu G, Chen S, Wu Y et al. Association between arterial stiffness and new-onset heart failure: the Kailuan study. Arterioscler Thromb Vasc Biol. 2023;43(2): e104 e111. doi:10.1161/ATVBAHA.122.317715Zheng H, Wu S, Liu X, Qiu G, Chen S, Wu Y et al. Association between arterial stiffness and new-onset heart failure: the Kailuan study. Arterioscler Thromb Vasc Biol. 2023;43(2): e104 e111. doi:10.1161/ATVBAHA.122.317715Chow B, Rabkin SW. The relationship between arterial stiffness and heart failure with preserved ejection fraction: a systemic meta-analysis. Heart Fail Rev. 2015;20(3):291–303. doi:10.1007/s10741-015-9471-1Chow B, Rabkin SW. The relationship between arterial stiffness and heart failure with preserved ejection fraction: a systemic meta-analysis. Heart Fail Rev. 2015;20(3):291–303. doi:10.1007/s10741-015-9471-1Huang WM, Sung SH, Yu WC, Cheng HM, Huang CJ, Guo CY et al. Perturbations of pulsatile hemodynamics and clinical outcomes in patients with acute heart failure and reduced, mid-range or preserved ejection fraction. PLoS One. 2019;14(8): e0220183. doi:10.1371/journal.pone.0220183Huang WM, Sung SH, Yu WC, Cheng HM, Huang CJ, Guo CY et al. Perturbations of pulsatile hemodynamics and clinical outcomes in patients with acute heart failure and reduced, mid-range or preserved ejection fraction. PLoS One. 2019;14(8): e0220183. doi:10.1371/journal.pone.0220183Anastasio F, Testa M, Ferreri C, Rossi A, Ruocco G, Feola M.The analysis of arterial stiffness in heart failure patients: the prognostic role of pulse wave velocity, augmentation index and stiffness index. J Clin Med. 2022;11(12):3507. doi:10.3390/jcm11123507Anastasio F, Testa M, Ferreri C, Rossi A, Ruocco G, Feola M.The analysis of arterial stiffness in heart failure patients: the prognostic role of pulse wave velocity, augmentation index and stiffness index. J Clin Med. 2022;11(12):3507. doi:10.3390/jcm11123507Kim HL, Chung J, Han S, Joh HS, Lim WH, Seo JB et al. Arterial stiffness and its associations with left ventricular diastolic function according to heart failure types. Clin Hypertens. 2023;29(1):8. doi:10.1186/s40885-022-00233-2Kim HL, Chung J, Han S, Joh HS, Lim WH, Seo JB et al. Arterial stiffness and its associations with left ventricular diastolic function according to heart failure types. Clin Hypertens. 2023;29(1):8. doi:10.1186/s40885-022-00233-2Desai AS, Mitchell GF, Fang JC, Creager MA. Central aortic stiffness is increased in patients with heart failure and preserved ejection fraction. J Card Fail. 2009;15(8):658–664. doi:10.1016/j.cardfail.2009.03.006Desai AS, Mitchell GF, Fang JC, Creager MA. Central aortic stiffness is increased in patients with heart failure and preserved ejection fraction. J Card Fail. 2009;15(8):658–664. doi:10.1016/j.cardfail.2009.03.006Weber T, Wassertheurer S, O’Rourke MF, Haiden A, Zweiker R, Rammer M et al. Pulsatile hemodynamics in patients with exertional dyspnea: potentially of value in the diagnostic evaluation of suspected heart failure with preserved ejection fraction. J Am Coll Cardiol. 2013;61(18):1874–1883. doi:10.1016/j.jacc.2013.02.013Weber T, Wassertheurer S, O’Rourke MF, Haiden A, Zweiker R, Rammer M et al. Pulsatile hemodynamics in patients with exertional dyspnea: potentially of value in the diagnostic evaluation of suspected heart failure with preserved ejection fraction. J Am Coll Cardiol. 2013;61(18):1874–1883. doi:10.1016/j.jacc.2013.02.013Zhang H, Hu W, Wang Y, Liu J, You L, Dong Q et al. The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study. BMC Cardiovasc Disord. 2022;22(1):246. doi:10.1186/s12872-022-02679-6Zhang H, Hu W, Wang Y, Liu J, You L, Dong Q et al. The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study. BMC Cardiovasc Disord. 2022;22(1):246. doi:10.1186/s12872-022-02679-6Ali D, Tran P, Ennis S, Powell R, McGuire S, McGregor G et al. Rising arterial stiffness with accumulating comorbidities associates with heart failure with preserved ejection fraction. ESC Heart Fail. 2023;10(4):2487–2498. doi:10.1002/ehf2.14422Ali D, Tran P, Ennis S, Powell R, McGuire S, McGregor G et al. Rising arterial stiffness with accumulating comorbidities associates with heart failure with preserved ejection fraction. ESC Heart Fail. 2023;10(4):2487–2498. doi:10.1002/ehf2.14422Kim DB, Baek SH, Jang SW, Her SH, Shin DI, Park CS et al. Improvement of arterial stiffness in the transition from acute decompensated heart failure to chronic compensated heart failure. Clin Cardiol. 2013;36(6):358–362. doi:10.1002/clc.22127Kim DB, Baek SH, Jang SW, Her SH, Shin DI, Park CS et al. Improvement of arterial stiffness in the transition from acute decompensated heart failure to chronic compensated heart failure. Clin Cardiol. 2013;36(6):358–362. doi:10.1002/clc.22127El Fol A, Ammar W, Sharaf Y, Youssef G. The central arterial stiffness parameters in decompensated versus compensated states of heart failure: a paired comparative cohort study. Egypt HeartJ. 2022;74(1):2. doi:10.1186/s43044-021-00236-8El Fol A, Ammar W, Sharaf Y, Youssef G. The central arterial stiffness parameters in decompensated versus compensated states of heart failure: a paired comparative cohort study. Egypt HeartJ. 2022;74(1):2. doi:10.1186/s43044-021-00236-82020 Clinical practice guidelines for chronic heart failure. Russian Journal of Cardiology. 2020;25(11):4083. doi:10.15829/1560-4071-2020-4083 In Russian.Хроническая сердечная недостаточность. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;25(11):4083. doi:10.15829/1560-4071-2020-4083.McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al.; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022;24(1):4–131. doi:10.1002/ejhf.2333McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al.; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022;24(1):4–131. doi:10.1002/ejhf.2333McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al.; ESC Scientific Document Group. 2023 focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023;44(37):3627–3639. doi:10.1093/eurheartj/ehad195McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al.; ESC Scientific Document Group. 2023 focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023;44(37):3627–3639. doi:10.1093/eurheartj/ehad195Vatsik-Gorodetskaya M, Tolkacheva V, Cabello-Montoya F, Sarlykov B, Nazarov I, Galotchkin S et al. Comprehensive assessment of the hydration status in patients with acute decompensated heart failure: clinical associations and prognostic significance. Klinicheskaya Farmakologiya i Terapiya = Clin Pharmacol Ther. 2023;32(1):42– 48. doi:10.32756/0869-5490-2023-1-42-48. In Russian.Вацик-Городецкая М. В., Толкачева В. В., Кабельо Монтойа Ф. Э., Сарлыков Б. К., Назаров И. С., ГалочкинС. А. и др. Комплексная оценка статуса гидратации у пациентов с острой декомпенсацией хронической сердечной недостаточности: клинические ассоциации и прогностическое значение. Клиническая фармакология и терапия. 2023;32(1):42–48. doi:10.32756/0869-5490-2023-1-42-48.Herbert A, Cruickshank JK, Laurent S, Boutouyrie P; Reference Values for Arterial Measurements Collaboration. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. Eur HeartJ. 2014;35(44):3122–3133. doi:10.1093/eurheartj/ehu293Herbert A, Cruickshank JK, Laurent S, Boutouyrie P; Reference Values for Arterial Measurements Collaboration. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. Eur HeartJ. 2014;35(44):3122–3133. doi:10.1093/eurheartj/ehu293Park HW, Corban M, Toya T, Ahmad A, Ozcan I, Lerman L et al. Impact of invasive aortic pulse pressure on coronary microvascular endothelial-independent dysfunction and on mortality in non-obstructive coronary artery disease. Open Heart. 2022;9(1): e001925. doi:10.1136/openhrt-2021-001925Park HW, Corban M, Toya T, Ahmad A, Ozcan I, Lerman L et al. Impact of invasive aortic pulse pressure on coronary microvascular endothelial-independent dysfunction and on mortality in non-obstructive coronary artery disease. Open Heart. 2022;9(1): e001925. doi:10.1136/openhrt-2021-001925Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: “establishing normal and reference values”. Eur Heart J. 2010;31(19):2338–2350. doi:10.1093/eurheartj/ehq165Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: “establishing normal and reference values”. Eur Heart J. 2010;31(19):2338–2350. doi:10.1093/eurheartj/ehq165Lu Y, Zhu Y, Ma Y, Li C, Hua R, Zhong B et al. Association of subclinical atherosclerosis and cognitive decline: a communitybased cross-sectional study. BMJ Open. 2022;12(5):e059024. doi:10.1136/bmjopen-2021-059024Lu Y, Zhu Y, Ma Y, Li C, Hua R, Zhong B et al. Association of subclinical atherosclerosis and cognitive decline: a communitybased cross-sectional study. BMJ Open. 2022;12(5):e059024. doi:10.1136/bmjopen-2021-059024Beaubien-Souligny W, Rola P, Haycock K, Bouchard J, Lamarche Y, Spiegel R et al. Quantifying systemic congestion with point-of-care ultrasound: development of the venous excess ultrasound grading system. Ultrasound J. 2020;12(1):16. doi:10.1186/s13089-020-00163-wBeaubien-Souligny W, Rola P, Haycock K, Bouchard J, Lamarche Y, Spiegel R et al. Quantifying systemic congestion with point-of-care ultrasound: development of the venous excess ultrasound grading system. Ultrasound J. 2020;12(1):16. doi:10.1186/s13089-020-00163-wPietschner R, Bosch A, Kannenkeril D, Striepe K, Schiffer M, Achenbach S et al. Is vascular remodelling in patients with chronic heart failure exaggerated? ESC Heart Fail. 2023; 10(1):245–254. doi:10.1002/ehf2.14174Pietschner R, Bosch A, Kannenkeril D, Striepe K, Schiffer M, Achenbach S et al. Is vascular remodelling in patients with chronic heart failure exaggerated? ESC Heart Fail. 2023; 10(1):245–254. doi:10.1002/ehf2.14174Fantin F, Giani A, Franconi A, Zoico E, Urbani S, Rossi AP et al. Arterial stiffness, subendocardial impairment, and 30 day readmission in heart failure older patients. Front Cardiovasc Med. 2022;9:918601. doi:10.3389/fcvm.2022.918601Fantin F, Giani A, Franconi A, Zoico E, Urbani S, Rossi AP et al. Arterial stiffness, subendocardial impairment, and 30 day readmission in heart failure older patients. Front Cardiovasc Med. 2022;9:918601. doi:10.3389/fcvm.2022.918601Tartière JM, Logeart D, Safar ME, Cohen-SolalA.Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure. J Hum Hypertens. 2006;20(3):213–219. doi:10.1038/sj.jhh.1001965Tartière JM, Logeart D, Safar ME, Cohen-Sola lA. Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure. J Hum Hypertens. 2006;20(3):213–219. doi:10.1038/sj.jhh.1001965Feola M, Testa M, Ferreri C, Rosso G, Rossi A, Ruocco G.The analysis of arterial stiffness in heart failure patients in comparison with healthy subjects and patients with cardiovascular risk factors. J Clin Med. 2019;8(10):1721. doi:10.3390/jcm8101721Feola M, Testa M, Ferreri C, Rosso G, Rossi A, Ruocco G.The analysis of arterial stiffness in heart failure patients in comparison with healthy subjects and patients with cardiovascular risk factors. J Clin Med. 2019;8(10):1721. doi:10.3390/jcm8101721Feola M.An update on the role of arterial stiffness in heart failure and the treatment of dyslipidemia. J Clin Med. 2023;12(9):3270. doi:10.3390/jcm12093270Feola M.An update on the role of arterial stiffness in heart failure and the treatment of dyslipidemia. J Clin Med. 2023;12(9):3270. doi:10.3390/jcm12093270Jackson CE, Castagno D, Maggioni AP, Køber L, Squire IB, Swedberg K et al.; Meta-Analysis Global Group in Chronic Heart Failure MAGGIC. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis. Eur HeartJ. 2015;36(18):1106–1114. doi:10.1093/eurheartj/ehu490Jackson CE, Castagno D, Maggioni AP, Køber L, Squire IB, Swedberg K et al.; Meta-Analysis Global Group in Chronic Heart Failure MAGGIC. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis. Eur HeartJ. 2015;36(18):1106–1114. doi:10.1093/eurheartj/ehu490Regnault V, Lagrange J, Pizard A, Safar ME, Fay R, Pitt B et al. Opposite predictive value of pulse pressure and aortic pulse wave velocity on heart failure with reduced left ventricular ejection fraction: insights from an Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) substudy. Hypertension. 2014;63(1):105–111. doi:10.1161/HYPERTENSIONAHA.113.02046Regnault V, Lagrange J, Pizard A, Safar ME, Fay R, Pitt B et al. Opposite predictive value of pulse pressure and aortic pulse wave velocity on heart failure with reduced left ventricular ejection fraction: insights from an Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) substudy. Hypertension. 2014;63(1):105–111. doi:10.1161/ HYPERTENSIONAHA.113.02046Troitskaya EA, Velmakin SV, Goreva LA, Kobalava ZhD. Aortic-brachial stiffness mismatch as potential marker of subclinical arterial damage in patients with rheumatoid arthritis. RUDN Journal of Medicine. 2023;27(2):167–181. doi:10.22363/2313-0245-2023- 27-2-167-181. In Russian.Троицкая Е. А., Вельмакин С. В., Горева Л. А., Кобалава Ж. Д. Несоответствие жесткости аорты и плеча как потенциальный маркер субклинического поражения артерий у пациентов с ревматоидным артритом. Медицинский журнал РУДН. 2023;27(2):167–181. doi:10.22363/2313-0245-2023-27-2-167-181.Troitskaya EA, Starostina ES, Kobalava Zh D. Prevalence of subclinical damage of peripheral arteries in patients with type 2 diabetes mellitus and arterial hypertension. Klinicheskaya Farmakologiya i Terapiya = Clin Pharmacol Ther. 2017;26(4):34–38. In Russian.Троицкая Е. А., Старостина Е. С., Кобалава Ж.Д. Распространенность суррогатных маркеров атеросклероза и артериальной ригидности у пациентов с сахарным диабетом 2 го типа и артериальной гипертонией. Клиническая фармакология и терапия. 2017;26(4):34–38.Троицкая Е. А., Старостина Е. С., Кобалава Ж.Д. Распространенность суррогатных маркеров атеросклероза и артериальной ригидности у пациентов с сахарным диабетом 2 го типа и артериальной гипертонией. Клиническая фармакология и терапия. 2017;26(4):34–38.

The authors declare that there are no conflicts of interest present.