Fluctuation of Dynamic Diastolic Function Relative to Static Cardiac Structure　― New Insights Into the Underlying Mechanism of Heart Failure With Preserved Ejection Fraction in Elderly Patients

Background:The mechanisms of heart failure with preserved ejection fraction (HFpEF) need to be clarified immediately.Methods and Results:We examined diastolic function relative to arterial elasticity among hypertensive patients with preserved EF. Diastolic elastance (EdI)/effective arterial elastance (EaI), EdI/EaI=E/e’/(0.9×systolic blood pressure [SBP]) was significantly more impaired in women than in men among patients ≥75 years. The higher EdI/EaI value in elderly women implies they are intermittently exposed to higher left ventricular filling pressure relative to SBP during daily life.Conclusions:Highly fluctuating impairment of diastolic function relative to arterial elasticity may predispose elderly women to pulmonary edema.