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Association of Echocardiographic Ventricular-Arterial Coupling With Elevated 10-Year ASCVD Risk in Hypertensive

Shiyi Zhang1,2, Jianxiong Chen3, Lan Yang4

  • 1Department of Obstetrics and Gynecology Ultrasound, Shanghai General Hospital, Shanghai Jiao tong University School of Medicine, Shanghai, China.

Echocardiography (Mount Kisco, N.Y.)
|July 11, 2026
PubMed

Insights

The arterial velocity pulse index-to-left ventricular global longitudinal strain ratio (AVI/LVGLS) is linked to higher atherosclerotic cardiovascular disease (ASCVD) risk in hypertensive patients. This ratio may aid in cardiovascular risk stratification.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Biomedical Engineering

Background:

  • Hypertension is a major risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • Accurate cardiovascular risk stratification is crucial for managing hypertensive patients.
  • Ventricular-arterial coupling (VAC) reflects the interaction between the heart and blood vessels.

Purpose of the Study:

  • To investigate the association between the arterial velocity pulse index-to-left ventricular global longitudinal strain ratio (AVI/LVGLS) and estimated 10-year ASCVD risk in hypertensive patients.
  • To assess the potential of AVI/LVGLS as a marker for cardiovascular risk stratification.

Main Methods:

  • A study included 190 hypertensive patients and 203 controls.
  • Ventricular-arterial coupling (VAC) was assessed using the AVI/LVGLS ratio.
  • Least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression analyses were used to evaluate the association with ASCVD risk.

Main Results:

  • The AVI/LVGLS ratio was significantly higher in hypertensive patients compared to controls.
  • AVI/LVGLS was identified as a predictor of high estimated ASCVD risk and showed superior discriminatory performance.
  • A low AVI/LVGLS ratio (below the fifth percentile) was independently associated with high estimated ASCVD risk in hypertensive patients.

Conclusions:

  • Ventricular-arterial coupling (VAC), measured by the AVI/LVGLS ratio, is independently associated with increased estimated ASCVD risk in hypertension.
  • The AVI/LVGLS ratio may reflect integrated myocardial and vascular changes.
  • AVI/LVGLS could serve as a complementary tool for cardiovascular risk stratification in hypertensive individuals.
Abstract

Keywords:
aortic velocity pulse indexechocardiographyglobal longitudinal strainhypertensionventricular‐arterial coupling

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