Association of Arterial Stiffness with Atrioventricular Coupling and Left Atrial Phasic Function in Patients with Hypertension

Jinling Liu; Xiaolin Mu; Yang Song; Lei Zhang; Zhe Xu; Wenjia Wang; Peishi Yan

doi:10.1093/ajh/hpaf117

Association of Arterial Stiffness with Atrioventricular Coupling and Left Atrial Phasic Function in Patients with Hypertension

Am J Hypertens. 2025 Jun 29:hpaf117. doi: 10.1093/ajh/hpaf117. Online ahead of print.

Authors

Jinling Liu¹, Xiaolin Mu², Yang Song², Lei Zhang¹, Zhe Xu², Wenjia Wang³, Peishi Yan¹

Affiliations

¹ Department of Cardiology, Central Hospital of Dalian University of Technology, Dalian, People's Republic of China.
² Department of Radiology, Central Hospital of Dalian University of Technology, Dalian, People's Republic of China.
³ MR Research Center China, GE Health Care, Beijing, People's Republic of China.

PMID: 40581771
DOI: 10.1093/ajh/hpaf117

Abstract

Background: Hypertension (HTN) predisposes individuals to arterial stiffness (AS) and dysfunction of the left atrial (LA) and left ventricular (LV). AS, characterized by increased pulse wave velocity (PWV) may impair LA phasic function. This study investigates the associations of brachial-ankle PWV and the left atrioventricular coupling index (LACI) as well as LA phasic function in hypertensive patients, and to evaluate the predictive value for LA dysfunction.

Methods: A prospective cohort of 150 patients with essential hypertension was enrolled. Patients were stratified into Group I (baPWV < 1600 cm/s, n = 75) and Group II (baPWV ≥ 1600 cm/s, n = 75) based on the median baPWV. Intergroup comparisons were performed. Correlations were assessed. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of baPWV.

Results: Compared with Group I, Group II exhibited reduced LAEFtotal, LAEFpass, εs, and εe (all P < 0.05). LACI was significantly higher in Group II (P < 0.05). After adjusting for cardiovascular risk factors, multivariate linear regression analysis revealed that baPWV remained independently associated with LAVImin, LACI, εs, and εe. baPWV integration with conventional risk factors significantly improved predictive performance.The AUC increased from 0.709 to 0.845 for LACI, from 0.681 to 0.892 for LAVImin, from 0.672 to 0.881 for εs, and from 0.685 to 0.919 for εe.

Conclusion: Hypertension-mediated AS exhibits concurrent abnormalities in LA-arterial and LA-LV-arterial coupling. Integrating baPWV into conventional risk stratification models enhances the predictive value for preclinical cardiac target organ damage in hypertension.

Keywords: Arterial stiffness; Cardiac MR; Hypertension; Left atrial; Pulse wave velocity.

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