Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
Am J Physiol Heart Circ Physiol. 2023 Aug 1;325(2):H362-H371. doi: 10.1152/ajpheart.00179.2023. Epub 2023 Jun 30.
Ventricular-arterial coupling (VAC) has independent diagnostic and prognostic value for cardiovascular (CV) risk stratification, but studies on its association with anthropometric and CV factors are sparse in young individuals without overt CV disease. We aim to provide descriptive data regarding VAC and its associations with CV risk factors in young adults without overt CV disease. For 631 (mean age, 24 ± 3 yr; 51% female) individuals, VAC was determined by carotid-femoral pulse wave velocity (PWV)/global longitudinal strain (GLS). Multivariable logistic and linear regression models were performed to explore the association between PWV/GLS and CV risk factors. A value < 0.05 was considered statistically significant. The mean PWV/GLS was 0.33 ± 0.07 m/s%. Higher ratios of PWV/GLS associated with older age, male sex, and a higher prevalence of CV risk factors (i.e., higher blood pressure, prevalent hypertension, higher waist circumference, active smoking, higher plasma triglycerides, lower high-density lipoprotein cholesterol, and an adverse urine albumin/creatinine ratio). Furthermore, higher PWV/GLS was associated with echocardiographic measures such as lower ejection fraction and higher left ventricle mass index. In expanded logistic regression models, higher ratios of PWV/GLS were significantly associated with the prevalence of active smoking [odds ratio (OR), 1.88; confidence interval (CI) 1.36-2.58, < 0.001] and hypertension (OR 1.98; CI 1.40-2.80, < 0.001). We demonstrated that worse VAC reflected by higher values of PWV/GLS are significantly associated with CV risk factors in young adults. The results suggest that PWV/GLS might serve as a tool to improve the profiling of cardiovascular risk in young adults. Assessing VAC is especially useful in heart failure and valvular heart disease, but less is known about VAC in the pathophysiology of CV disease risk in younger individuals. In young individuals without overt CV disease, we showed descriptive data regarding VAC, determined by PWV/GLS ratio, and explored the associations of VAC with clinical CV disease risk factors. Worse VAC, reflected by higher values of PWV/GLS, associated with high blood pressure and smoking in young adults.
心室-动脉偶联（VAC）对心血管（CV）风险分层具有独立的诊断和预后价值，但在没有明显 CV 疾病的年轻人群中，关于其与人体测量和 CV 因素之间的关系的研究很少。我们旨在提供关于 VAC 的描述性数据及其与无明显 CV 疾病的年轻成年人 CV 危险因素的相关性。对 631 名（平均年龄 24±3 岁，51%为女性）个体进行了颈动脉-股动脉脉搏波速度（PWV）/整体纵向应变（GLS）的 VAC 测定。采用多变量逻辑回归和线性回归模型探讨了 PWV/GLS 与 CV 危险因素之间的关系。PWV/GLS 值＜0.05 被认为具有统计学意义。平均 PWV/GLS 为 0.33±0.07 m/s%。较高的 PWV/GLS 比值与年龄较大、男性以及较高的 CV 危险因素患病率相关（即血压较高、已确诊的高血压、较高的腰围、主动吸烟、较高的血浆甘油三酯、较低的高密度脂蛋白胆固醇和不良的尿白蛋白/肌酐比值）。此外，较高的 PWV/GLS 与超声心动图指标相关，如射血分数降低和左心室质量指数增加。在扩展的逻辑回归模型中，较高的 PWV/GLS 比值与主动吸烟的患病率显著相关（比值比 1.88；95%置信区间 1.36-2.58， ＜0.001）和高血压（比值比 1.98；95%置信区间 1.40-2.80， ＜0.001）。我们表明，PWV/GLS 比值较高反映的较差的 VAC 与年轻成年人的 CV 危险因素显著相关。结果表明，PWV/GLS 比值可能是一种用于改善年轻成年人心血管风险评估的工具。评估 VAC 在心衰和瓣膜性心脏病中尤其有用，但在年轻个体的 CV 疾病风险的病理生理学中，对 VAC 的了解较少。在没有明显 CV 疾病的年轻个体中，我们提供了通过 PWV/GLS 比值确定的 VAC 的描述性数据，并探讨了 VAC 与临床 CV 疾病危险因素的相关性。PWV/GLS 比值较高反映的较差的 VAC 与年轻成年人的高血压和吸烟相关。
