Cardio-Vascular Interaction Evaluated by Speckle-Tracking Echocardiography and Cardio-Ankle Vascular Index in Hypertensive Patients

Figure 1. Comparison of biatrial and biventricular strain in the CAVI value. Biatrial reservoir and conduit strain in those with abnormal CAVI were significantly lower than those with normal CAVI. Data are presented as mean ± standard deviation. CAVI, cardio-ankle vascular index; LA, left atrium; RA, right atrium; LVGLS, left ventricular global longitudinal strain; RVFWS, right ventricular free wall longitudinal strain.

Figure 2. Correlations between the CAVI value and biatrial and biventricular strain. CAVI was correlated with LA reservoir strain (r = −0.387, p = 0.0001), LA conduit strain (r = −0.448, p = 0.0001), and RA conduit strain (r = −0.238, p = 0.003). The solid line represents the regression line. CAVI, cardio-ankle vascular index; LA, left atrium; RA, right atrium; LVGLS, left ventricular global longitudinal strain; RVFWS, right ventricular free wall longitudinal strain.

Figure 3. Cardiovascular interaction. Systemic circulation is pumped by the left ventricle but supported by the right ventricle. The left ventricle and all vessels are composed of the aorta, muscular artery, arteriole, and vein. Each artery has its own function. CAVI reflects vascular function of the aorta and muscle.

Figure 4. Flow chart showing patient selection. CAVI, cardio-ankle vascular index; LVEF, left ventricular ejection fraction.

Figure 5. Analysis of longitudinal strain in a 4-chamber view. Dotted lines depict the average curve of the six segments. (A,B): The first positive peak of the curve is the peak atrial strain during ventricular systole, measured at the end of the reservoir phase (RASr and LASr). The peak defection is followed by a plateau and peak atrial strain in late diastole at the onset of the P wave on the electrocardiogram, just before the active atrial pump (RASp and LASp) begins. RA conduit (RASc) is calculated as the difference between RASr and RASp. LA conduit (LASc) is calculated as the difference between LASr and LASp. (C,D): Longitudinal strain of RV and LV was analyzed as the average of negative peak strain (RVFWS and LVGLS). RA, right atrium; LA, left atrium; RV, right ventricle; LV, left ventricle; RVFWS, right ventricular free wall longitudinal strain; LVGLS, left ventricular global longitudinal strain.