Dynamic aortic stiffness response to exercise as a marker of functional capacity in early-stage heart failure
Clinical Physiology and Functional Imaging, cilt.46, sa.3, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 46 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1111/cpf.70066
- Dergi Adı: Clinical Physiology and Functional Imaging
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, SportDiscus, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: aortic stiffness, exercise capacity, heart failure, vascular compliance, ventricular-arterial interaction
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: Aortic stiffness increases ventricular afterload and limits exercise capacity in heart failure (HF), but its dynamic response to exercise remains insufficiently defined. This study aimed to evaluate exercise-induced changes in aortic stiffness and their association with functional capacity in patients with early-stage HF. Heart-rate recovery (HRR) was assessed as secondary parameter. Methods: This prospective study enrolled 42 compensated HF patients (ejection fraction <45%) in sinus rhythm. Aortic diameters were measured 3 cm above the aortic valve using M-mode echocardiography to calculate the Stiffness Index (SI), Peterson's Elastic Modulus (Ep), and Aortic Distensibility (D). All patients underwent a symptom-limited treadmill test using the modified Bruce protocol. HRR was defined as the difference between peak heart rate and heart rate at 1 min of recovery. Echocardiographic measurements were repeated within 60 s after exercise. Results: Aortic stiffness increased significantly after exercise [SI: 5.05 (4.18–6.30) to 6.03 (4.59–7.79); p < 0.001], while distensibility decreased [2.64 to 1.90 ×10 − 6 cm2·dyn−1; p < 0.001]. Patients with NYHA class II had higher SI and Ep and lower D at rest and post- exercise than NYHA class I patients (all p < 0.001). NYHA class was the only independent predictor of post-exercise stiffness (β = 3.32; 95% CI 1.33–5.30; p = 0.002). Exercise capacity was significantly lower in NYHA II patients (7.0 vs 10.1 METs; p < 0.001). HRR showed no significant association with aortic stiffness or exercise capacity. Conclusions: In early-stage HF, increased resting and exercise-induced aortic stiffness is strongly associated with reduced functional capacity, indicating early impairment of vascular compliance reserve during physiological stress.