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Moving the Goalposts in Hypertensive Risk Assessment: The AVI/LVGLS Ratio as a Sensitive Detector of Maladaptive
Giancarlo Trimarchi1,2, Fausto Pizzino2, Massimiliano Mariani2
1Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
Echocardiography (Mount Kisco, N.Y.)
|July 11, 2026
Summary
The arterial velocity-pulse index to left ventricular global longitudinal strain (AVI/LVGLS) ratio shows promise for assessing cardiovascular risk in hypertension. This non-invasive marker may improve risk stratification beyond traditional methods.
Area of Science:
- Cardiology
- Echocardiography
- Vascular Physiology
Background:
- Hypertension poses significant cardiovascular risks.
- Conventional risk assessment may not fully capture subclinical disease.
- Ventricular-arterial coupling (VAC) is crucial for cardiovascular health.
Purpose of the Study:
- To discuss the AVI/LVGLS ratio as a novel, non-invasive marker for assessing VAC.
- To evaluate its utility in refining cardiovascular risk assessment in hypertensive patients.
- To integrate findings with existing knowledge on arterial stiffness and myocardial function.
Main Methods:
- Critical appraisal of a study by Zhang et al. evaluating the AVI/LVGLS ratio and 10-year ASCVD risk.
- Integration of findings with prior research on arterial stiffness, myocardial deformation, and VAC.
- Analysis of echocardiography-derived parameters.
Main Results:
- The AVI/LVGLS ratio was significantly different between hypertensive patients and controls.
- AVI/LVGLS was independently associated with elevated 10-year ASCVD risk.
- The AVI/LVGLS ratio demonstrated superior discrimination for cardiovascular risk compared to individual components or conventional indices.
Conclusions:
- The AVI/LVGLS ratio offers a practical, non-invasive method for phenotyping vascular and myocardial function in hypertension.
- It serves as a sensitive indicator of maladaptive VAC and subclinical cardiovascular risk.
- Further multicenter validation is needed for routine clinical implementation.
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