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[Preprint]. 2025 Mar 27:rs.3.rs-6189873.
doi: 10.21203/rs.3.rs-6189873/v1.

Assessment of Ventricular-Arterial Coupling in Early Stage Middle-Aged Hypertensives

Andrea Vitali  1 , Giuseppe Biondi Zoccai  2 , George Booz  2 , Raffaele Altara  3
Affiliations

Assessment of Ventricular-Arterial Coupling in Early Stage Middle-Aged Hypertensives

Andrea Vitali et al. Res Sq. .

Update in

Abstract

Background: Ventricular-arterial coupling (VAC) is altered by aging and cardiovascular comorbidities, indicating myocardial dysfunction and/or arterial stiffness. Our aim was to demonstrate whether lifestyle changes and anti-hypertensive drug treatment would improve VAC in recently diagnosed, early stage middle-aged hypertensives (HTN) without organ damage.

Methods: Arterial elastance (Ea), carotid-femoral pulse wave velocity (cfPWV), global longitudinal strain (GLS), and myocardial work (MW) [global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE)] were investigated. This retrospective observational study involved 126 individuals (mean age 40 years; 55% female), divided into HTN and normotensives, NT. Clinical, echocardiographic and echo vascular parameters were assessed. Lifestyle changes were recommended for HTN. If blood pressure (BP) values still remained high, anti-hypertensive drug treatment was administered.

Results: Higher values of systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate (HR), GWI, GCW, and GWW were observed in HTN. By following lifestyle changes, BP [diastolic blood pressure (DBP) and MAP], HR, VAC, Ea, cfPWV, GWE, and GLS were changed in HTN; after 6 months of anti-hypertensive drug treatment, BP (SBP, DBP and MAP), HR, VAC, Ea, cfPWV, GWI, GCW, GWW, GWE, and GLS were found to be changed. VAC was linearly related to cfPWV and GLS at two follow ups. No statistically significant difference in VAC between HTN and NT was found.

Conclusions: Along with a decrease in BP, smoking cessation, and HR control highlighted a significant role in cardiovascular prevention by improvement of VAC, Ea, cfPWV, GLS and MW.

Keywords: arterial elastance; arterial hypertension; global longitudinal strain; myocardial work; pulse wave velocity.

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Conflict of interest statement

Conflicts of Interest The authors affirm that they have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Clinical and echocardiographic parameters in HTN. BSA, body surface area; IVST, interventricular septum thickness; PWT, posterior wall thickness; RWT, relative wall thickness; LVEDD, left ventricular end diastolic diameter; LVESD, left ventricular end systolic diameter; E/e’ ratio, E wave / e’ wave ratio; ABI, ankle brachial index.
Figure 2
Figure 2
BP, HR and echocardiographic parameters in HTN. SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; HR, heart rate; EF, ejection fraction; SV, stroke volume; Svi, stroke volume index; LAVi, left atrial volume index.
Figure 3
Figure 3
MW components, echocardiographic and echo vascular parameters GLS, cfPWV, Ea, VAC in the study population (HTN). MW, Myocardial Work; GWI, global work index; GCW, global constructive work; GWW, global wasted work; GWE. global work efficiency; GLS, global longitudinal strain; cfPWV, carotid femoral Pulse Wave Velocity; Ea, arterial elastance; VAC, ventricular-arterial coupling.
Figure 4
Figure 4
Multiple linear regression (impact of each variable on VAC) HTN at Day 0. B0, intercept; B1, age; B2, current smokers; B3, current drinkers; B4, systolic blood pressure; B5, diastolic blood pressure; B6, mean arterial pressure; B7, heart rate; B8, body surface area; B9, interventricular septum thickness; B10, posterior wall thickness; B11, relative wall thickness; B12, left ventricular end diastolic diameter; B13, left ventricular end systolic diameter; B14, ejection fraction; B15, stroke volume; B16, stroke volume index; B17, left atrial volume index; B18, E/e’ ratio; B19, global work efficiency; B20. global work index; B21, global constructed work; B22, global wasted work; B23, global longitudinal strain; B24, carotid femoral Pulse Wave Velocity; B25, ankle-brachial index; B26, arterial elastance.
Figure 5
Figure 5
Multiple linear regression (impact of each variable on VAC) HTN at 6 months. B0, intercept; B1, current smokers; B2, current drinkers; B3, age; B4, systolic blood pressure; B5, diastolic blood pressure; B6, mean arterial pressure; B7, heart rate; B8, body surface area; B9, interventricular septum thickness; B10, posterior wall thickness; B11, relative wall thickness; B12, left ventricular end diastolic diameter; B13, left ventricular end systolic diameter; B14, ejection fraction; B15, stroke volume; B16, stroke volume index; B17, left atrial volume index; B18, E/e’ ratio; B19, global work efficiency; B20, global work index; B21, global constructed work; B22, global wasted work; B23, global longitudinal strain; B24, carotid femoral Pulse Wave Velocity; B25, ankle-brachial index; B26, arterial elastance.
Figure 6
Figure 6
Multiple linear regression (impact of each variable on VAC) HTN at 12 months. B0, intercept; B1, current smokers; B2, current drinkers; B3, age; B4, systolic blood pressure; B5, diastolic blood pressure; B6, mean arterial pressure; B7, heart rate; B8, body surface area; B9, interventricular septum thickness; B10, posterior wall thickness; B11, relative wall thickness; B12, left ventricular end diastolic diameter; B13, left ventricular end systolic diameter; B14, ejection fraction; B15, stroke volume; B16, stroke volume index; B17, left atrial volume index; B18, E/e’ ratio; B19, global work efficiency; B20, global work index; B21, global constructed work; B22, global wasted work; B23, global longitudinal strain; B24, carotid femoral Pulse Wave Velocity; B25, ankle-brachial index; B26, arterial elastance.
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