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. 2019 Feb;49(2):e13049.
doi: 10.1111/eci.13049. Epub 2018 Dec 19.

Pulse wave velocity to global longitudinal strain ratio in hypertension

Ignatios Ikonomidis  1 , Spyridon Katsanos  1 , Hellen Triantafyllidi  1 , John Parissis  1 , Stavros Tzortzis  1 , George Pavlidis  1 , Paraskevi Trivilou  1 , Georgios Makavos  1 , Maria Varoudi  1 , Alexandra Frogoudaki  1 , Agathi-Rosa Vrettou  1 , Dimitrios Vlastos  1 , John Lekakis  1 , Efstathios Iliodromitis  1
Affiliations

Pulse wave velocity to global longitudinal strain ratio in hypertension

Ignatios Ikonomidis et al. Eur J Clin Invest. 2019 Feb.

Abstract

Background: Arterial elastance to left ventricular elastance ratio assessed by echocardiography is widely used as a marker of ventricular-arterial coupling.

Materials and methods: We investigated whether the ratio of carotid-femoral pulse wave velocity, as a marker of arterial stiffness, to global longitudinal strain, as a marker of left ventricular performance, could be better associated with vascular and cardiac damage than the established arterial elastance/left ventricular elastance index. In 299 newly-diagnosed untreated hypertensives we measured, carotid-femoral pulse wave velocity, and carotid intima-media thickness, coronary-flow reserve, arterial elastance/left ventricular elastance, global longitudinal strain, and markers of left ventricular diastolic function (E/A and E') by echocardiography.

Results: Pulse wave velocity-to-global longitudinal strain ratio (PWV/GLS) was lower in hypertensives than controls (-0.61 ± 0.21 vs -0.45 ± 0.11 m/sec%, P < 0.001). Low PWV/GLS values were associated with carotid-intima media thickness > 0.9 mm (P = 0.003), E/A ≤ 0.8 (P = 0.019) and E' ≤ 9 cm/sec (P = 0.002) and coronary-flow reserve < 2.5 (P = 0.017), after adjustment for age, sex and mean arterial pressure. Low PWV/GLS was also associated with increased left ventricular mass and left atrial volume in the univariate (P = 0.003 and 0.038) but not in the multivariate model. In hypertensives, there was no significant association of arterial elastance-to-left ventricular elastance index with carotid intima media thickness, coronary flow reserve, E/A, E', or left atrial volume with the exception of an inverse association with left ventricular mass (P = 0.027).

Conclusions: Pulse wave velocity-to-global longitudinal strain ratio but not the echocardiography-derived arterial elastance-to left ventricular elastance index is related to impaired carotid-intima media thickness, coronary-flow reserve and diastolic function in hypertensives.

Keywords: arterial ventricular coupling; global longitudinal strain; hypertension; pulse wave velocity.

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