Response to Letter Regarding Article, “Cardiac Structure and Ventricular–Vascular Function in Persons With Heart Failure and Preserved Ejection Fraction From Olmsted County, Minnesota”

We appreciate the comments of Tartiere et al on our study1 and agree that these are valid concerns about the noninvasive estimation of systolic vascular and ventricular stiffness. As acknowledged in our paper, “Although total vascular load and indirect measures of vascular stiffness were obtained here, further study is needed to evaluate more direct and perhaps regional measures of vascular stiffening and other assessments of arterial impedance and its impact such as characteristic impedance, wave reflections, and pulse-wave velocity.” Whereas effective arterial elastance, derived from …