Femoral Plaque Burden and Left Ventricular–Arterial Coupling in Patients with Chronic Heart Failure

<b>Background/Objectives:</b> Lower extremity peripheral artery disease (PAD) is recognized as a significant public health issue, particularly due to its strong association with adverse cardiovascular events. Despite this, little attention has been given to its influence on left ventricular (LV) and left atrial (LA) function in patients with chronic heart failure (CHF). This study aims to examine the relationship between femoral plaque burden and structural and functional properties of the LV and LA in patients with CHF. <b>Methods:</b> Study design: cross-sectional observational single-center study. A total of 89 patients with CHF underwent comprehensive assessments, including duplex ultrasonography of lower extremity arteries and two-dimensional echocardiography. Analysis focused on evaluating femoral plaque burden, left ventricular deformation, and ventricular-arterial coupling. <b>Results:</b> Findings indicated that increased femoral plaque burden was associated with reductions in LA deformation and increases in LA stiffness. Similarly, there was evidence of impaired LV mechanics and elevated arterial loading, suggesting impaired ventricular-arterial coupling in patients with CHF and significant lower extremity atherosclerosis. <b>Conclusions:</b> Femoral plaque burden is closely linked to detrimental changes in LA and LV function, as well as disturbances in ventricular-arterial coupling, underscoring the importance of addressing lower extremity atherosclerosis in managing CHF patients.