Background: Number of heart failure patients with preserved systolic function increases with every year, vascular load is one of the leading determinants in ventriculo-vascular coupling and ventricular function.

Aim: to assess endothelial function by photoplethismografy and arterial stiffness on perindopril therapy in HF patients with preserved systolic function.

Methods: 50 patients with exertional dyspnoe were included in the study, I-II NYHA, EF>45%, ethiology of HF - hypertention, aged 62,3(±8,4), female 56%, BMI 29,9 kg/m². Arterial stiffness was measured by applanation tonometry (Sphygmocor): carotid-femoral PWV and MAP, central pulse pressure (PP), aortic augmentation index (AIX); endothelial function was assessed by photoplethismografy using low arm occlusion, clinical status with MQLHF and 6-minutes walk-test (6MWT) at baseline and in 12-months. All patients were on perindopril therapy, start dose 4mg, mean dose 8 mg.

Results: 12-months therapy resulted in improvement of endothelial function, decreasing of arterial stiffness, clinical improvement. PWV decreased from 10 (8,6;11,9) to 8,8(8,1;11) (p=0,05); endothelial function improved from 1,25[1,09;1,52] to 1,42[1,2;1,64] (p<0,05), parameters of central hemodynamics changed: MAP from 105,5 (97,5;115,5) to 102(97;106) mmHg; CSBP from 145(132;152) to 130(122;138)mmHg; CDBP from 85(79;93) to 80 (79;87)mmHg; AIX from 29,5[24,5;34,5] to 28[22;32] . Clinical status: NYHA FC from 2(1;2) to 1(1;1), MQLHF from 39,5(27;47) to 32(24;39), 6MWT from 390(375;420) to 460(450;470).

Conclusions: 12-months perindopril therapy improved endothelial function, led to reduction of arterial stiffness and resulted in improvement of clinical status of diastolic HF patients, that suggests that perindopril should be considered therapeutically usefull in diastolic HF treatment.