Key result
Higher composite afterload index is linked to worse left atrial-ventricular coupling index per SD.
Why the study?
Brachial blood pressure may not fully capture the multidimensional arterial load affecting left atrial-left ventricular coupling in hypertensive phenotypes.
Does a higher composite multidomain arterial afterload index correlate with worse left atrial-left ventricular coupling in adult cardiology inpatients?
Cross-Sectional (n=336)
No
Does a higher composite multidomain arterial afterload index correlate with worse left atrial-left ventricular coupling in adult cardiology inpatients?
Mean Difference: 0.0142 (95% CI 0.0011–0.0273)
p-value: p=0.033
A composite index of multidomain arterial afterload correlates with worse left atrial-left ventricular coupling, suggesting that combined noninvasive vascular assessments provide information on early cardiac dysfunction complementary to brachial blood pressure alone.
Composite afterload index was associated with worse LA-LV coupling; supports hypothesis that multidomain measures add to brachial BP but leaves open prospective validation.
Brachial blood pressure may not fully reflect the multidimensional arterial load associated with left atrial-left ventricular (LA-LV) coupling. In this cross-sectional study, we examined local carotid pulse wave velocity (PWV), cuff-derived arterial pressure-volume index (API), and arterial velocity-pulse index (AVI), separately and as a composite afterload index (ACI), in 336 inpatients (71 controls, 183 with hypertension, and 82 with hypertension and type 2 diabetes). Covariate-adjusted linear models related standardized exposures to the left atrial stiffness index (LASI) and LA-LV coupling index (LACI). Greater ACI was associated with higher LACI (β = 0.0142 per 1-SD, 95% CI 0.0011-0.0273; p = 0.033). The LASI estimate was directionally similar but less precise (β = 0.0232, 95% CI -0.0024-0.0488; p = 0.076), and all single-domain CIs included zero. These findings support further evaluation of accessible multidomain vascular assessment as a complement to brachial blood pressure. External calibration and longitudinal validation are needed to establish the clinical value of ACI.
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Luo et al. (2026) conducted a cross-sectional in Hypertension and Type 2 Diabetes (n=336). Composite afterload index (ACI) comprising local carotid PWV, API, and AVI was evaluated on Left atrial-left ventricular coupling index (LACI) (β = 0.0142 per 1-SD, 95% CI 0.0011-0.0273, p=0.033). A greater multidomain composite afterload index (ACI) was significantly associated with a higher left atrial-left ventricular coupling index (β = 0.0142 per 1-SD, p=0.033).
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