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Updated: Sep 18, 2025
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Published on: June 20, 2025
Higher Physical Activity Is Associated with Improved Ventricular-Arterial Coupling: Assessment Using the cfPWV/GLS
Paula-Anca Sulea1,2, Ioan Tilea2, Florin Stoica1,2
1Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania.
Background:
Age-related vascular stiffening increases cardiovascular risk by altering ventricular-arterial coupling (VAC). Physical activity, a modifiable factor, may improve cardiovascular health. This pilot study evaluated the relationship between physical activity evaluation and VAC, measured by the carotid-femoral pulse wave velocity to global longitudinal strain (cfPWV/GLS) ratio, in a Romanian primary care cohort.
Methods:
The prospective cohort analysis was performed on 81 adults (49 females, mean age 50.27 ± 12.93 years). Physical activity was quantified through anamnesis using metabolic equivalents (METs) according with Compendium of Physical Activities, and patients were stratified into four groups: G1 (METs < 1.5, n = 39), G2 (METs = 1.5-2.9, n = 2), G3 (METs = 3-5.9, n = 23), and G4 (METs ≥ 6, n = 17). Demographic and echocardiographic data were recorded to explore associations between physical activity and VAC.
Results:
The cfPWV/GLS ratio differed significantly across groups (p = 0.012), with the lowest values present in the moderate-intensity group (G3). VAC ≥ 0.391 can predict sedentary lifestyles (AUC = 0.730; CI: 0.617-0.833, p > 0.001). Multivariate analysis revealed that age, arterial age, and hypertension independently predict VAC.
Conclusions:
Higher physical activity is inversely associated with VAC (cfPWV/GLS ratio) and can predict sedentary lifestyles. Encouraging moderate-to-vigorous exercise in primary care may improve cardiovascular function and aid prevention.
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