The AVI/LVGLS ratio was independently associated with elevated estimated 10-year ASCVD risk in hypertensive patients, demonstrating better discrimination than conventional indices alone.
Does the AVI/LVGLS ratio improve the detection of maladaptive ventricular-arterial coupling and subclinical cardiovascular risk in hypertensive patients compared to conventional indices?
The AVI/LVGLS ratio is a promising non-invasive marker of ventricular-arterial coupling that may improve ASCVD risk stratification in hypertensive patients.
PURPOSE: This commentary discusses the AVI/LVGLS ratio as an emerging, fully non-invasive marker of ventricular-arterial coupling (VAC) for refining cardiovascular risk assessment in hypertension beyond conventional indices such as left ventricular ejection fraction and Ea/Ees. METHODS: We critically appraised the study by Zhang et al., which evaluated the association between the arterial velocity-pulse index to left ventricular global longitudinal strain ratio and estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk in hypertensive patients. The commentary integrates these findings with prior evidence on arterial stiffness, myocardial deformation, and VAC assessment. RESULTS: Zhang et al. showed that AVI/LVGLS differed significantly between hypertensive patients and normotensive controls and was independently associated with elevated estimated 10-year ASCVD risk. An AVI/LVGLS ratio below the fifth percentile predicted high ASCVD risk after multivariable adjustment, while the composite index demonstrated better discrimination than AVI, LVGLS, or conventional ventricular-vascular index alone. These findings support the incremental value of combining vascular load and myocardial deformation into a single echocardiography-compatible parameter. CONCLUSION: AVI/LVGLS may provide a practical bridge between vascular and myocardial phenotyping in hypertension, offering a sensitive marker of maladaptive VAC and subclinical cardiovascular risk. Prospective, multicenter validation is required before implementation in routine risk stratification or therapeutic monitoring.
Trimarchi et al. (Wed,) conducted a editorial in Hypertension. AVI/LVGLS ratio vs. Normotensive controls was evaluated on Estimated 10-year ASCVD risk. The AVI/LVGLS ratio was independently associated with elevated estimated 10-year ASCVD risk in hypertensive patients, demonstrating better discrimination than conventional indices alone.