Correlation between Ventricular-Arterial Coupling and Global Longitudinal Strain in Hypertensive With Preserved Ejection Fraction

BACKGROUND Global longitudinal strain (GLS) of the left ventricle (LV), derived from speckle-tracking echocardiography (STE), has shown efficacy in reliably detecting LV systolic malfunction in diverse cardiovascular diseases. Ventricular-arterial coupling (VAC) is an indispensable indicator of cardiovascular efficacy. However, the relationship between GLS and VAC remains inadequately understood. Accordingly, we aimed to examine the connection between VAC and GLS in hypertensive patients with a preserved LV ejection fraction (EF). METHODS This cross-sectional study included 104 individuals with primary hypertension and 40 normotensive controls. Echocardiography-derived VAC was calculated as the quotient of effective arterial elastance (Ea) and end-systolic elastance (Ees)(Ea/Ees). In addition to conventional echocardiography, GLS was evaluated with two-dimensional (2D) STE. Ees, Ea, and the Ea/Ees ratio were calculated. Participants were categorized into tertiles according to their Ea/Ees values. RESULTS Median Ea/Ees values for the low, middle, and high tertile groups were 0.48 (0.46–0.50), 0.56 (0.55–0.58), and 0.67 (0.63–0.70), respectively. Simple regression analysis revealed a significant negative connection between GLS and Ea/Ees tertile (β = −0.276, P = 0.005). The link remained statistically significant subsequent to the adjustment for important confounding variables in the multiple regression analysis (β = −0.237, P = 0.007). The area under the ROC curve (AUC) for Ea/Ees in predicting abnormal GLS (absolute GLS < 20) was 0.656 (P = 0.010). CONCLUSIONS Ea/Ees is independently linked to GLS in hypertensive individuals with LV preserved EF. This suggests that Ea/Ees may serve as a predictor of LV subclinical systolic dysfunction, as evaluated through GLS. Registration No. NCT04573257.