Ventricular-arterial coupling derived from arterial velocity pulse index to global longitudinal strain ratio in hypertension

Abstract

Objective: Ventricular-arterial coupling (VAC) evaluates the relationship between the left ventricle (LV) and the arterial system. This study aimed to assess VAC using the ratio of arterial stiffness (arterial velocity pulse index [AVI]) to myocardial deformation (global longitudinal strain [GLS]) in hypertension, and to determine whether it is more closely associated with vascular and cardiac damage than the conventional arterial elastance/left ventricular elastance (Ea/Ees) index.

Methods: AVI, GLS, arterial elastance (Ea), left ventricular end-systolic elastance (Ees), left ventricular ejection fraction (LVEF), and markers of left ventricular diastolic function (E/A and E') were measured by echocardiography in 141 healthy controls and 141 hypertensive subjects.

Result: AVI/GLS ratio was significantly lower in hypertensive individuals compared to controls (-0.77±0.29 vs. -0.66±0.28, p=0.001). A low AVI/GLS ratio was correlated with age (r=-0.450, p<0.05) and LVEF (r=0.243, p<0.05). Receiver operating characteristic (ROC) analysis demonstrated that the AVI/GLS ratio had higher sensitivity for predicting early cardiovascular changes in hypertensive patients, with an area under the curve (AUC) of 0.645 (95% CI [0.565; 0.681]).

Conclusions: Hypertension is associated with worse ventricular-arterial coupling (VAC) when expressed by the AVI/GLS ratio compared to normal conditions. The AVI/GLS ratio proved to be more effective than traditional indices (Ea/Ees) in detecting differences in cardiovascular function in hypertensive individuals. The role of the AVI/GLS ratio in various clinical settings requires further investigation.

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