Ventricular-arterial coupling assessed by PWV/GLS ratio in hypertensive patients

Area of Science:

• Cardiology
• Vascular Physiology
• Biomedical Engineering

Background:

• Ventricular-arterial coupling (VAC) is crucial for optimal cardiac work and cardiovascular performance.
• Hypertension significantly impacts the interaction between the left ventricle and arterial system.
• Assessing VAC is vital for understanding cardiovascular health in hypertensive individuals.

Purpose of the Study:

• To evaluate the utility of the pulse wave velocity (PWV) to global longitudinal strain (GLS) ratio in assessing ventricular-arterial coupling (VAC).
• To compare VAC parameters in hypertensive patients with and without coronary artery disease against healthy controls.
• To identify a predictive threshold for altered VAC using the PWV/GLS ratio.

Main Methods:

• Calculated the PWV/GLS ratio in 135 participants across three groups: hypertensive patients with coronary artery disease (HT+CAD), hypertensive patients (HT), and healthy controls (CON).
• Measured pulse wave velocity (PWV) as a marker of arterial stiffness and global longitudinal strain (GLS) as a marker of left ventricular function.
• Utilized Receiver Operating Characteristic (ROC) curve analysis to determine the diagnostic threshold for altered VAC.

Main Results:

• Significantly reduced GLS and elevated PWV were observed in both HT+CAD and HT groups compared to controls (p<0.001).
• The PWV/GLS ratio was significantly lower in hypertensive groups (HT+CAD and HT) versus controls (p<0.001), indicating impaired VAC.
• An ROC curve analysis identified a PWV/GLS ratio threshold of -0.054 for detecting altered VAC with an AUROC of 0.836.

Conclusions:

• The PWV/GLS ratio is a valuable tool for detecting altered ventricular-arterial coupling in hypertensive patients.
• This ratio holds potential for monitoring early multi-organ damage and evaluating antihypertensive medication efficacy.
• Further extensive prospective studies are warranted to validate these findings and clinical applications.