Patients at risk for developing heart failure with preserved ejection fraction (HFpEF) will undergo a structured clinical assessment, transthoracic echocardiography and pulse-wave analysis to investigate the association of arterial stiffening and the development of cardiac diastolic dysfuntion and HFpEF.

Inclusion Criteria:

One or more of the following criteria:

• Age > 60 years
• Arterial hypertension (RR systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg or ≥ 2 antihypertensive drugs)
• Diabetes mellitus Type I or II
• Atrial fibrillation
• Chronic kidney disease (GFR < 60 ml/min/1,73 m2 or urine albumin ≥ 30mg/24h or ACR ≥ 30 mg/g)
• BMI ≥ 30 kg/m2
• NYHA ≥ II
• E/e' > 8

Exclusion Criteria:

• Left ventricular ejection fraction < 50 %
• Significant valve disease (Grade III or higher)
• History of interventional or surgical valve repair
• Regional wall motion abnormalities
• Respiratory diseases as a known cause for dyspnea
• Atrial flutter or fibrillation during examination
• Hypertrophic/restrictive/arrhythmogenic/dilatative cardiomyopathies including cardiac amyloidosis or sarcoidosis and toxic cardiomyopathy
• History of heart transplantation

Patients at risk for HFpEF