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Ventricular-arterial coupling : definition, pathophysiology and therapeutic targets in cardiovascular disease

Saeed, Sahrai ; Holm, Hannes LU and Nilsson, Peter M. LU (2021) In Expert Review of Cardiovascular Therapy 19(8). p.753-761
Abstract

Introduction: The heart and arterial system are equally affected by arteriosclerosis/atherosclerosis. There is a constant interaction between the left ventricular (LV) function and the arterial system, termed ventricular-arterial coupling (VAC), which reflects the global cardiovascular efficiency. VAC is traditionally assessed by echocardiography as the ratio of effective arterial elastance (Ea) over end-systolic elastance (Ees) (Ea/Ees). However, the concept of VAC is evolving and new methods have been proposed such as the ratio of pulse wave velocity (PWV) to global longitudinal strain (GLS) and myocardial work index. Area covered: This clinical review presents the hemodynamic background of... (More)

Introduction: The heart and arterial system are equally affected by arteriosclerosis/atherosclerosis. There is a constant interaction between the left ventricular (LV) function and the arterial system, termed ventricular-arterial coupling (VAC), which reflects the global cardiovascular efficiency. VAC is traditionally assessed by echocardiography as the ratio of effective arterial elastance (Ea) over end-systolic elastance (Ees) (Ea/Ees). However, the concept of VAC is evolving and new methods have been proposed such as the ratio of pulse wave velocity (PWV) to global longitudinal strain (GLS) and myocardial work index. Area covered: This clinical review presents the hemodynamic background of VAC, its clinical implications and the impact of therapeutic interventions to normalize VAC. The review also summarizes the detrimental effects of cardio-metabolic risk factors on the aorta and LV, and provides an update on arterial load and its impact on LV function. The narrative review is based upon a systemic search of the bibliographic database PubMed for publications on VAC. Expert opinion: Newer methods such as PWV/GLS-ratio may be a superior marker of VAC than the traditional echocardiographic Ea/Ees in predicting target organ damage and its association with clinical outcomes. Novel anti-diabetic drugs and optimal antihypertensive treatment may normalize VAC in high-risk patients.

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Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arterial load, diabetes, global longitudinal strain, pulse wave velocity, systolic left ventricular function, ventricular-arterial coupling
in
Expert Review of Cardiovascular Therapy
volume
19
issue
8
pages
9 pages
publisher
Future Drugs Ltd
external identifiers
  • pmid:34252318
  • scopus:85111582086
ISSN
1477-9072
DOI
10.1080/14779072.2021.1955351
language
English
LU publication?
yes
id
10059b45-7144-43b9-9299-7730a3045e08
date added to LUP
2021-08-30 11:45:51
date last changed
2025-01-26 14:25:29
@article{10059b45-7144-43b9-9299-7730a3045e08,
  abstract     = {{<p>Introduction: The heart and arterial system are equally affected by arteriosclerosis/atherosclerosis. There is a constant interaction between the left ventricular (LV) function and the arterial system, termed ventricular-arterial coupling (VAC), which reflects the global cardiovascular efficiency. VAC is traditionally assessed by echocardiography as the ratio of effective arterial elastance (E<sub>a</sub>) over end-systolic elastance (E<sub>es</sub>) (E<sub>a</sub>/E<sub>es</sub>). However, the concept of VAC is evolving and new methods have been proposed such as the ratio of pulse wave velocity (PWV) to global longitudinal strain (GLS) and myocardial work index. Area covered: This clinical review presents the hemodynamic background of VAC, its clinical implications and the impact of therapeutic interventions to normalize VAC. The review also summarizes the detrimental effects of cardio-metabolic risk factors on the aorta and LV, and provides an update on arterial load and its impact on LV function. The narrative review is based upon a systemic search of the bibliographic database PubMed for publications on VAC. Expert opinion: Newer methods such as PWV/GLS-ratio may be a superior marker of VAC than the traditional echocardiographic E<sub>a</sub>/E<sub>es</sub> in predicting target organ damage and its association with clinical outcomes. Novel anti-diabetic drugs and optimal antihypertensive treatment may normalize VAC in high-risk patients.</p>}},
  author       = {{Saeed, Sahrai and Holm, Hannes and Nilsson, Peter M.}},
  issn         = {{1477-9072}},
  keywords     = {{Arterial load; diabetes; global longitudinal strain; pulse wave velocity; systolic left ventricular function; ventricular-arterial coupling}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{753--761}},
  publisher    = {{Future Drugs Ltd}},
  series       = {{Expert Review of Cardiovascular Therapy}},
  title        = {{Ventricular-arterial coupling : definition, pathophysiology and therapeutic targets in cardiovascular disease}},
  url          = {{http://dx.doi.org/10.1080/14779072.2021.1955351}},
  doi          = {{10.1080/14779072.2021.1955351}},
  volume       = {{19}},
  year         = {{2021}},
}