Measurement of Endothelial Function and Cardiac Output: New Methods

Inclusion Criteria

• •Clinically stable for the last 4 weeks (not for HFrEF: 7 days)
• •Signed consent form
• •HFpEF:
• •Baseline-Echocardiography:
• •hospitalization \<= 12 months with diagnosis heart failure and E/E' \> 8 or E' \< 8 cm/s or
• •BNP \>= 100pg/ml or NT-proBNP \>= 300pg/ml in the last 6 months or
• •LAVI \> 28 ml/m² and E/E' \> 8 or E' \< 8cm/s or PAPsys \> 40mmHg and E/E' \> 8 or E' \< 8 cm/s
• •Possibility to take part in cardiac stress test
• •Heart failure NYHA I-III
• •Sinus rhythm
• •Max. O2-uptake on exertion \< 20ml/kgBW/min
• •HFrEF
• •HFrEF due to ischemic or non-ischemic reasons
• •NYHA I-III
• •Individually optimized and stable pharmacological therapy (including beta-blocker, ACE-Inhibitor, AT1-antagonist, aldosterone-antagonist)
• •EF \<=45%, Simpson Biplan PH
• •NICE-Classification 2013 I/II
• •PAH \>= 25 mmHg
• •Precapillary PAH: Wedge-pressure \<= 15 mmHg, CO normal or low
• •Postcapillary PAH: Wedge-pressure \>= 15 mmHg, CO normal or low
• •Diabetic nephropathy:
• •Diabetes mellitus Type 2 with oral or Insulin therapy and one or more of the following:
• •Diabetic nephropathy has been diagnosed before (anamnesis)
• •Macroalbuminuria: Urine Albumine/Creatinine-ratio \> 300mg/g Creatinine (\>34mg/mmol) in 2 out of 3 tests of Urine in the morning and GFR \<90ml/min/1.73m² (CKD-EPI)
• •Microalbuminuria: 30-300mg/g Creatinine (\>=3.4 mg/mmol but \<34mg/mmol) tested as above and GFR \< 90 ml/min/1.73m² and diabetic retinopathy
• •AH:
• •Hypertension diagnosed at least 6 months except structural heart disease: EF \> 55% and no sign of HFpEF
• •No symptoms of coronary heart disease
• •Possibility to take part in cardiac stress test
• •Stable pharmacologic therapy of Hypertension for at least 4 weeks
• •Systolic blood pressure \<140 mmHG during Screening