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

Abstract

Hypertension increases arterial stiffness, leading to dysfunction and structural changes in the left atrium (LA) and left ventricle (LV). However, the effects of hypertension on the right atrium (RA) and the right ventricle are still not fully understood. The purpose of this study was to clarify whether there is an interaction not only in the left ventricular system but also in the right ventricular system in hypertensive patients with preserved LV ejection fraction. The current retrospective observational study included patients (n = 858) with some risk of metabolic abnormalities (hypertension, diabetes, and dyslipidemia) who had visited our hospital and undergone echocardiography between 2015 and 2018. Among them, we retrospectively studied 165 consecutive hypertensive patients with preserved LV ejection fraction who had echocardiography performed on the same day as a cardio-ankle vascular index (CAVI) in our hospital. The phasic function of both atria was evaluated by two-dimensional speckle-tracking echocardiography. CAVI was measured using Vasela 1500 (Fukuda Denshi®). In the univariate analysis, CAVI was significantly correlated with LA and RA conduit function (LA conduit function, r = −0.448, p = 0.0001; RA conduit function, r = −0.231, p = 0.003). A multivariate regression analysis revealed that LA and RA conduit function was independently associated with CAVI (LA, t = −5.418, p = 0.0001; RA, t = −2.113, p = 0.036). CAVI showed a possibility that the association between heart and vessels are contained from not only LA phasic function but also RA phasic function in hypertensive patients.

A Case of Young Obese Heart Failure Patient Using Multidisciplinary Treatment Centered on the Fantastic Four Improved Cardio Ankle Vascular Index and Cardiac Function

“…Cardiovascular interaction has recently been demonstrated using CAVI, not only in the left heart system but also in the right heart system. 9,10 Recently, much evidence has been reported on SGLT2 inhibitors and ARNI for heart failure. [11][12][13] However, there has not yet been a report using CAVI that focuses on effects of the "Fantastic Four" on the cardiovascular interaction.…”

Hypertension‐specific association of cardio‐ankle vascular index with subclinical left ventricular function in a Chinese population: Danyang study

“…First, hypertension is an established risk factor for abnormal GLS regarded as an early and sensitive marker of subclinical LV systolic dysfunction. 25 In addition, it has been reported that increased CAVI is associated with worse cardiac structure and function in hypertensive patients, 26,27 suggesting that hypertension appeared to mediate the associations of CAVI with worse cardiac structure and function. Further investigations of the hypertension-specific pathophysiological mechanisms are warranted.…”

Challenges in Echocardiography for the Diagnosis and Prognosis of Non-Ischemic Hypertensive Heart Disease

“…Most recently, there is a growing body of evidence about the clinical utility of the speckle tracking of the RV [109]. It undergoes remodeling in many cardiac conditions, among them HHD [24].…”