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Review
. 2013 Oct-Dec;23(4):91-95.
doi: 10.4103/2211-4122.127408.

The Ventricular-Arterial Coupling: From Basic Pathophysiology to Clinical Application in the Echocardiography Laboratory

Francesco Antonini-Canterin  1 , Stefano Poli  1   2 , Olga Vriz  3 , Daniela Pavan  4 , Vitantonio Di Bello  5 , Gian Luigi Nicolosi  6
Affiliations
Review

The Ventricular-Arterial Coupling: From Basic Pathophysiology to Clinical Application in the Echocardiography Laboratory

Francesco Antonini-Canterin et al. J Cardiovasc Echogr. 2013 Oct-Dec.

Abstract

The interplay between cardiac function and arterial system, which in turn affects ventricular performance, is defined commonly ventricular-arterial coupling and is an expression of global cardiovascular efficiency. This relation can be expressed in mathematical terms as the ratio between arterial elastance (EA) and end-systolic elastance (EES) of the left ventricle (LV). The noninvasive calculation requires complicated formulae, which can be, however, easily implemented in computerized algorithms, allowing the adoption of this index in the clinical evaluation of patients. This review summarizes the up-to-date literature on the topic, with particular focus on the main clinical studies, which range over different clinical scenarios, namely hypertension, heart failure, coronary artery disease, and valvular heart disease.

Keywords: Echocardiography; hypertension; left ventricular function; ventricular-arterial coupling.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Relation between stroke volume and end-systolic arterial pressure. The slope of the relation is the arterial elastance (EA), which can be easily calculated by the ratio between end-systolic pressure and stroke volume, since the relation intercepts the point zero
Figure 2
Figure 2
Relation between end-systolic left ventricular pressure and end-systolic left ventricular volume. The slope of the relation in end-systolic elastance of the left ventricle (EES). Since this linear relation does not intercept the point zero, EES cannot be simply calculated by the ratio between end-systolic pressure and end-systolic volume
Figure 3
Figure 3
The echo figures display the evaluation of ejection fraction (panel A), time-velocity integral (VTI), preejection and ejection time (panel B) using aortic pulsed-Doppler waveform on the left ventricular outflow tract (LVOT). These parameters, along with systolic and diastolic and systolic blood pressure and LVOT diameter, allow the correct determination of EA/EES ratio
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