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Pulse wave velocity to global longitudinal strain ratio in hypertension

Ignatios Ikonomidis1, Spyridon Katsanos1, Hellen Triantafyllidi1

  • 12nd Department of Cardiology, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece.

European Journal of Clinical Investigation
|November 14, 2018
PubMed

Insights

The pulse wave velocity-to-global longitudinal strain ratio better identifies vascular and cardiac damage in hypertension than the arterial elastance/left ventricular elastance index. This new ratio is linked to impaired arterial stiffness and diastolic function.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Hypertension Research

Background:

  • Ventricular-arterial coupling is crucial for cardiovascular health.
  • The arterial elastance to left ventricular elastance ratio is a common echocardiographic marker.
  • Assessing this coupling aids in understanding cardiovascular damage in hypertension.

Purpose of the Study:

  • To evaluate the carotid-femoral pulse wave velocity to global longitudinal strain ratio (PWV/GLS) as a superior marker of vascular and cardiac damage.
  • To compare the association of PWV/GLS with established markers against the arterial elastance/left ventricular elastance index.
  • To investigate associations with carotid intima-media thickness, coronary-flow reserve, and diastolic function in hypertensive patients.

Main Methods:

  • Carotid-femoral pulse wave velocity (PWV) and global longitudinal strain (GLS) were measured in 299 newly-diagnosed, untreated hypertensive patients.
  • Echocardiography assessed left ventricular elastance, diastolic function (E/A, E'), and left ventricular mass.
  • Carotid intima-media thickness and coronary-flow reserve were also evaluated.

Main Results:

  • The PWV/GLS ratio was significantly lower in hypertensives compared to controls.
  • Low PWV/GLS values correlated with increased carotid intima-media thickness, impaired diastolic function (E/A, E'), and reduced coronary-flow reserve.
  • The arterial elastance/left ventricular elastance index showed limited associations with these markers, except for left ventricular mass.

Conclusions:

  • The PWV/GLS ratio is a more effective indicator of vascular and cardiac damage in hypertension than the echocardiography-derived arterial elastance/left ventricular elastance index.
  • PWV/GLS is significantly related to impaired carotid intima-media thickness, coronary-flow reserve, and diastolic function.
  • This ratio offers a promising approach for assessing cardiovascular risk in hypertensive individuals.
Abstract

Keywords:
arterial ventricular couplingglobal longitudinal strainhypertensionpulse wave velocity

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