Over the past few years, there has been a growing appreciation that a large number of patients with heart failure have a relatively normal (or preserved) ejection fraction (NFNEF). Epidemiologically, HFNEF is most prevalent among elderly women, most of whom have hypertension, diabetes, or both and often coronary artery disease (CAD). Increased arterial stiffness and/or wave reflections have been described in the same patient groups. Therefore, the investigators speculate that pulsatile hemodynamics, representing arterial stiffness and/or arterial wave reflections, 1) may be altered in HFNEF patients, 2) this may contribute to pathophysiology of HFNEF, and 3) this may be used for the diagnosis of the syndrome.

Inclusion Criteria:

• exertional dyspnea
• undergoing heart catheterization for diagnosis or exclusion of coronary artery disease
• normal EF (> 50%)

Exclusion Criteria:

• atrial fibrillation
• more than mild valvular heart disease
• pericardial disease
• no informed consent

Patients undergoing invasive assessment for exertional dyspnea