Saba Pier Sergio, Cameli Matteo, Casalnuovo Giuseppina, Ciccone Marco M, Ganau Antonello, Maiello Maria, Modesti Pietro A, Muiesan Maria L, Novo Salvatore, Palmiero Pasquale, Sanna Giuseppe D, Scicchitano Pietro, Pedrinelli Roberto
aCardiologia, Azienda Ospedaliero-Universitaria di Sassari, Sassari bDepartment of Cardiovascular Diseases, University of Siena, Siena cCardiovascular Disease Section, Department of Emergency and Organ Transplantation, University of Bari, Bari dAS Department of Cardiology, Brindisi District eDepartment of Clinical and Experimental Medicine, University of Florence, Florence fClinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia gDepartment of Internal Medicine and Cardiovascular Diseases, Palermo hDipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy.
J Cardiovasc Med (Hagerstown). 2014 Nov;15(11):773-87. doi: 10.2459/JCM.0000000000000146.
The present review is addressed to analyse the complex interplay between left ventricle and arterial tree in hypertension. The different methodological approaches to the analysis of ventricular vascular coupling in the time and frequency domain are discussed. Moreover, the role of hypertension-related changes of arterial structure and function (stiffness and wave reflection) on arterial load and how ventricular-vascular coupling modulates the process of left ventricular adaptation to hypertension are analysed.The different interplay between vascular bed and left ventricle emerges as the pathophysiological basis for the development of the multiple patterns of ventricular structural adaptation in hypertension and provides a pathway for the interpretation of systolic and diastolic functional abnormalities observed in hypertensive patients. Targeting the therapeutic approach to improve ventricular-vascular coupling may have relevant impact on reversing left ventricular hypertrophy and improving systolic and diastolic dysfunction.
本综述旨在分析高血压患者左心室与动脉系统之间复杂的相互作用。讨论了在时域和频域分析心室血管耦合的不同方法。此外，还分析了动脉结构和功能（僵硬度和波反射）与高血压相关的变化对动脉负荷的作用，以及心室血管耦合如何调节左心室适应高血压的过程。血管床与左心室之间不同的相互作用是高血压患者心室结构适应多种模式发展的病理生理基础，并为解释高血压患者观察到的收缩和舒张功能异常提供了途径。针对改善心室血管耦合的治疗方法可能对逆转左心室肥厚和改善收缩及舒张功能障碍具有重要影响。
