Background and Objectives: Arterial stiffness as determined by artery pulse wave velocity (PWV) is increased according to the increment of afterload. A plasma BNP level>400 pg/ml was used as a reliable marker of the diagnosis of congestive heart failure (CHF) and a plasma BNP concentration <100 pg/ml was used to rule out CHF. The aim of this study was to evaluate the possibility of PWV as early predictor of CHF Methods and Results: Regional PWVs were measured by noninvasive automatic device in patients with NYHA class III to IV CHF (n=32) confirmed by clinical symptoms, plasma BNP level and echocardiography (LVEF<50%), and in normal control group (n=58) (age: 63.6짹9.2 vs. 70.1짹12.0 years, p=0.08). The level of central arterial (carotid-femoral) PWV was higher in CHF groups than in control group (9.21짹1.38m/s vs. 7.79짹0.90m/s, p<0.001). There was no difference between in the two groups (p=0.778 and p=0.134, respectively) of peripheral arterial (femoral-dorsalis and carotid-radial) PWV. The level of central arterial PWV was higher in the group which was more than 100ng/L BNP (9.01짹1.18m/s vs. 7.919짹1.21m/s, p<0.001). The plasma level of hsCRP was higher in CHF group than in normal group (1.96짹1.82 vs. 0.41짹0.62, p<0.001) and hsCRP was correlated with central arterial PWV (r=0.25, p=0.037), but not peripheral arterial PWV (r=0.09, p=0.43). Central arterial PWV was not correlated with E/A and E���/A��� ratio was measured by Doppler echocardiogram in CHF group (p=0.20 and 0.14 respectively). Conclusion: Central arterial PWV show significant increment by the cut-off value of the plasma level of 100ng/L BNP in CHF, therefore central arterial PWV could predict CHF in low level of BNP.