{"title":"估计脉搏波速度与整体纵向应变比:区分心力衰竭亚型的工具?","authors":"Ying Wang, Min Lu","doi":"10.1159/000546345","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Ventricular-arterial coupling (VAC), which refers to harmonious interaction between the ventricles and arteries, is essential for maintenance of optimal cardiovascular function. The ratio of the pulse wave velocity (PWV) to left ventricular global longitudinal strain (GLS) has been established as a reliable noninvasive metric for assessing VAC.</p><p><strong>Aims: </strong>This study aimed to assess VAC noninvasively in heart failure (HF) using the estimated pulse wave velocity (ePWV) to GLS ratio, defined from speckle tracking imaging.</p><p><strong>Methods: </strong>According to the HF stages by the American Heart Association, 131 subjects were divided into four groups: group 1 (n = 36) at risk of developing HF and pre-HF (American College of Cardiology/American Heart Association stages A and B), group 2 (n = 35) having HF with preserved ejection fraction (HFpEF), group 3 (n = 35) having HF with reduced ejection fraction (HFrEF), and group 4 (n = 30) as controls. To determine the ePWV/GLS ratio, the ePWV was calculated based on the previously established formula using age and mean pressure, and the GLS was derived from speckle tracking echocardiography. The study evaluated the VAC in all groups and compared with the established metrics such as arterial elasticity (Ea) and ventricular end-systolic elasticity (Ees) ratios. The correlation between the ePWV/GLS ratio and other parameters obtained by echocardiography was also assessed.</p><p><strong>Results: </strong>Significant differences in the ePWV/GLS ratio were observed among the groups, and the severity of VAC impairment correlated with the HF stage. The lowest ePWV/GLS ratio was observed in the control and stage A-B group (0.530 ± 0.100 vs 0.640 ± 0.10), followed by the HFpEF group (0.992 ± 0.215), whereas the HFrEF group had the highest ratio (1.500 ± 0.369). The ePWV/GLS ratio showed a moderate correlation with the Ea/Ees ratio [r =0.753, (95% CI, 0.665-0.821), P <0.0001], but performed better in distinguishing HF subtypes. A threshold of 0.625 for the ePWV/GLS ratio was established by the ROC curve to detect the impaired VAC, with an AUROC of 0.923 and 95% CI of 0.876-0.969. In addition, the ePWV/GLS ratio was strongly associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and moderately correlated with left ventricular mass index (LVMI), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), age, and E/e'.</p><p><strong>Conclusion: </strong>The ePWV/GLS ratio is an easily accessible parameter for evaluating VAC. It is closely related to the HF stage and can effectively differentiate between HF subtypes. Although the ratio was higher in patients with HFpEF than in healthy individuals, it was lower than in patients with HFrEF.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Estimated Pulse Wave Velocity to Global Longitudinal Strain Ratio: A Tool for Differentiating Heart Failure Subtypes?\",\"authors\":\"Ying Wang, Min Lu\",\"doi\":\"10.1159/000546345\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Ventricular-arterial coupling (VAC), which refers to harmonious interaction between the ventricles and arteries, is essential for maintenance of optimal cardiovascular function. The ratio of the pulse wave velocity (PWV) to left ventricular global longitudinal strain (GLS) has been established as a reliable noninvasive metric for assessing VAC.</p><p><strong>Aims: </strong>This study aimed to assess VAC noninvasively in heart failure (HF) using the estimated pulse wave velocity (ePWV) to GLS ratio, defined from speckle tracking imaging.</p><p><strong>Methods: </strong>According to the HF stages by the American Heart Association, 131 subjects were divided into four groups: group 1 (n = 36) at risk of developing HF and pre-HF (American College of Cardiology/American Heart Association stages A and B), group 2 (n = 35) having HF with preserved ejection fraction (HFpEF), group 3 (n = 35) having HF with reduced ejection fraction (HFrEF), and group 4 (n = 30) as controls. To determine the ePWV/GLS ratio, the ePWV was calculated based on the previously established formula using age and mean pressure, and the GLS was derived from speckle tracking echocardiography. The study evaluated the VAC in all groups and compared with the established metrics such as arterial elasticity (Ea) and ventricular end-systolic elasticity (Ees) ratios. The correlation between the ePWV/GLS ratio and other parameters obtained by echocardiography was also assessed.</p><p><strong>Results: </strong>Significant differences in the ePWV/GLS ratio were observed among the groups, and the severity of VAC impairment correlated with the HF stage. The lowest ePWV/GLS ratio was observed in the control and stage A-B group (0.530 ± 0.100 vs 0.640 ± 0.10), followed by the HFpEF group (0.992 ± 0.215), whereas the HFrEF group had the highest ratio (1.500 ± 0.369). The ePWV/GLS ratio showed a moderate correlation with the Ea/Ees ratio [r =0.753, (95% CI, 0.665-0.821), P <0.0001], but performed better in distinguishing HF subtypes. A threshold of 0.625 for the ePWV/GLS ratio was established by the ROC curve to detect the impaired VAC, with an AUROC of 0.923 and 95% CI of 0.876-0.969. In addition, the ePWV/GLS ratio was strongly associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and moderately correlated with left ventricular mass index (LVMI), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), age, and E/e'.</p><p><strong>Conclusion: </strong>The ePWV/GLS ratio is an easily accessible parameter for evaluating VAC. It is closely related to the HF stage and can effectively differentiate between HF subtypes. Although the ratio was higher in patients with HFpEF than in healthy individuals, it was lower than in patients with HFrEF.</p>\",\"PeriodicalId\":9391,\"journal\":{\"name\":\"Cardiology\",\"volume\":\" \",\"pages\":\"1-15\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-05-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000546345\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000546345","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Estimated Pulse Wave Velocity to Global Longitudinal Strain Ratio: A Tool for Differentiating Heart Failure Subtypes?
Background: Ventricular-arterial coupling (VAC), which refers to harmonious interaction between the ventricles and arteries, is essential for maintenance of optimal cardiovascular function. The ratio of the pulse wave velocity (PWV) to left ventricular global longitudinal strain (GLS) has been established as a reliable noninvasive metric for assessing VAC.
Aims: This study aimed to assess VAC noninvasively in heart failure (HF) using the estimated pulse wave velocity (ePWV) to GLS ratio, defined from speckle tracking imaging.
Methods: According to the HF stages by the American Heart Association, 131 subjects were divided into four groups: group 1 (n = 36) at risk of developing HF and pre-HF (American College of Cardiology/American Heart Association stages A and B), group 2 (n = 35) having HF with preserved ejection fraction (HFpEF), group 3 (n = 35) having HF with reduced ejection fraction (HFrEF), and group 4 (n = 30) as controls. To determine the ePWV/GLS ratio, the ePWV was calculated based on the previously established formula using age and mean pressure, and the GLS was derived from speckle tracking echocardiography. The study evaluated the VAC in all groups and compared with the established metrics such as arterial elasticity (Ea) and ventricular end-systolic elasticity (Ees) ratios. The correlation between the ePWV/GLS ratio and other parameters obtained by echocardiography was also assessed.
Results: Significant differences in the ePWV/GLS ratio were observed among the groups, and the severity of VAC impairment correlated with the HF stage. The lowest ePWV/GLS ratio was observed in the control and stage A-B group (0.530 ± 0.100 vs 0.640 ± 0.10), followed by the HFpEF group (0.992 ± 0.215), whereas the HFrEF group had the highest ratio (1.500 ± 0.369). The ePWV/GLS ratio showed a moderate correlation with the Ea/Ees ratio [r =0.753, (95% CI, 0.665-0.821), P <0.0001], but performed better in distinguishing HF subtypes. A threshold of 0.625 for the ePWV/GLS ratio was established by the ROC curve to detect the impaired VAC, with an AUROC of 0.923 and 95% CI of 0.876-0.969. In addition, the ePWV/GLS ratio was strongly associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and moderately correlated with left ventricular mass index (LVMI), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), age, and E/e'.
Conclusion: The ePWV/GLS ratio is an easily accessible parameter for evaluating VAC. It is closely related to the HF stage and can effectively differentiate between HF subtypes. Although the ratio was higher in patients with HFpEF than in healthy individuals, it was lower than in patients with HFrEF.
期刊介绍:
''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.