{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T09:08:36Z","timestamp":1779872916663,"version":"3.53.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Physio Funct Imaging"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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\u2010induced changes in aortic stiffness and their association with functional capacity in patients with early\u2010stage HF. Heart\u2010rate recovery (HRR) was assessed as secondary parameter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study enrolled 42 compensated HF patients (ejection fraction &lt;45%) in sinus rhythm. Aortic diameters were measured 3\u2009cm above the aortic valve using M\u2010mode echocardiography to calculate the Stiffness Index (SI), Peterson's Elastic Modulus (Ep), and Aortic Distensibility (D). All patients underwent a symptom\u2010limited treadmill test using the modified Bruce protocol. HRR was defined as the difference between peak heart rate and heart rate at 1\u2009min of recovery. Echocardiographic measurements were repeated within 60\u2009s after exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Aortic stiffness increased significantly after exercise [SI: 5.05 (4.18\u20136.30) to 6.03 (4.59\u20137.79);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001], while distensibility decreased [2.64 to 1.90\u2009\u00d710\u2009\u2212\u20096\u2009cm2\u00b7dyn\u22121;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]. Patients with NYHA class II had higher SI and Ep and lower D at rest and post\u2010 exercise than NYHA class I patients (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). NYHA class was the only independent predictor of post\u2010exercise stiffness (\u03b2\u2009=\u20093.32; 95% CI 1.33\u20135.30;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Exercise capacity was significantly lower in NYHA II patients (7.0 vs 10.1 METs;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). HRR showed no significant association with aortic stiffness or exercise capacity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In early\u2010stage HF, increased resting and exercise\u2010induced aortic stiffness is strongly associated with reduced functional capacity, indicating early impairment of vascular compliance reserve during physiological stress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cpf.70066","type":"journal-article","created":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T22:43:57Z","timestamp":1777848237000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic aortic stiffness response to exercise as a marker of functional capacity in early\u2010stage heart failure"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-4981","authenticated-orcid":false,"given":"Mustafa Ferhat","family":"Keten","sequence":"first","affiliation":[{"name":"Department of Cardiology Kos\u0327uyolu High Specialization Training and Research Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3667-7888","authenticated-orcid":false,"given":"Alev","family":"Kilicgedik","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bas\u0327aks\u0327ehir C\u0327am and Sakura City Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9714-2966","authenticated-orcid":false,"given":"Nesri","family":"Danisman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Siirt State Hospital Siirt Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1866-349X","authenticated-orcid":false,"given":"Ismail","family":"Balaban","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kos\u0327uyolu High Specialization Training and Research Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4140-9139","authenticated-orcid":false,"given":"Cemalettin","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yalova University of School Medicine Yalova Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0841-1301","authenticated-orcid":false,"given":"Kadir","family":"Biyikli","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kos\u0327uyolu High Specialization Training and Research Hospital Istanbul 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