BACKGROUND The ventricular-vascular coupling ratio, defined as the ratio of arterial elastance (Ea) to left ventricular end-systolic elastance (Ees), has not been examined in populations with coronary artery disease (CAD), and its association with heart failure (HF) in this population is unknown. METHODS Ventricular-vascular coupling was measured at rest and after exercise using echocardiography and cuff blood pressure in 815 patients with stable CAD enrolled in the Heart and Soul Study. Adjusted Cox proportional-hazard models were used to evaluate the association between ventricular-vascular coupling and future HF hospitalizations. RESULTS After a median of 8.9 years, 144 patients (18%) were hospitalized for HF. After multivariate adjustment, patients in the highest tertile of Ees (rest: hazard ratio [HR], 0.31 [95% CI, 0.17-0.57; P < .001]; exercise: HR, 0.26 [95% CI, 0.13-0.50; P < .001]) were at decreased risk for HF hospitalization, while patients in the highest tertile of the Ea/Ees ratio (rest: HR, 3.36 [95% CI, 1.91-5.93; P < .001]; exercise: HR, 4.09; [95% CI, 2.22-7.51; P < .001]) were at increased risk, compared with the lowest tertiles. Ea and the relative change observed in Ees and the Ea/Ees ratio with exercise were not associated with HF hospitalizations. CONCLUSIONS The Ea/Ees ratio and Ees, at rest and after exercise, are strongly associated with future HF hospitalizations in patients with stable CAD and low rates of baseline HF. Ventricular-vascular coupling obtained from echocardiography shows promise as a risk assessment tool for HF in patients with CAD.

中文翻译：

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冠状动脉疾病患者静息和运动后的心室-血管耦合与心力衰竭住院有关。

背景技术尚未在患有冠状动脉疾病（CAD）的人群中检查其心室-血管耦合比（定义为动脉弹性（Ea）与左室收缩末期弹性（Ees）之比）及其与心力衰竭的相关性（ HF）在这个人群中是未知的。方法参加心脏和灵魂研究的815例稳定CAD患者在运动时和运动后使用超声心动图和袖带血压测量了心室-血管耦合。调整后的Cox比例风险模型用于评估心室血管耦合与未来HF住院之间的关联。结果中位8.9年后，有144例患者（18％）因心衰而住院。经过多变量调整后，患者的三位一体Ees最高（休息：危险比[HR]为0.31 [95％CI，0.17-0.57； P <.001]；运动：HR，0.26 [95％CI，0.13-0.50；P <.001]）HF住院的风险降低，而Ea / Ees比最高三分位数的患者（休息：HR，3.36 [95％CI，1.91-5.93； P <.001]；运动：HR ，比最低的三分位数要高； 4.09； [95％CI，2.22-7.51； P <.001]）处于增加的风险中。Ea和运动时Ees的相对变化以及运动时Ea / Ees比率与心衰住院无关。结论稳定CAD和基线HF率低的患者，静息和运动后的Ea / Ees比和Ees与未来的HF住院密切相关。从超声心动图获得的心室-血管耦合显示出有望作为冠心病患者心衰的风险评估工具。而Ea / Ees比值最高的患者（其余：HR，3.36 [95％CI，1.91-5.93； P <.001]；运动：HR，4.09； [95％CI，2.22-7.51； P < [001]]的风险要高于最低的三分位数。Ea和运动时Ees的相对变化以及运动时Ea / Ees比率与心衰住院无关。结论稳定CAD和基线HF率低的患者，静息和运动后的Ea / Ees比和Ees与未来的HF住院密切相关。从超声心动图获得的心室-血管耦合显示出有望作为冠心病患者心衰的风险评估工具。而Ea / Ees比值最高的患者（其余：HR，3.36 [95％CI，1.91-5.93； P <.001]；运动：HR，4.09； [95％CI，2.22-7.51； P < [001]]的风险要高于最低的三分位数。Ea和运动时Ees的相对变化以及运动时Ea / Ees比率与心衰住院无关。结论稳定CAD和基线HF率低的患者，静息和运动后的Ea / Ees比和Ees与未来的HF住院密切相关。从超声心动图获得的心室-血管耦合显示出有望作为冠心病患者心衰的风险评估工具。与最低的三分位数相比。Ea和运动时Ees的相对变化以及运动时Ea / Ees比率与心衰住院无关。结论稳定CAD和基线HF率低的患者，静息和运动后的Ea / Ees比和Ees与未来的HF住院密切相关。从超声心动图获得的心室-血管耦合显示出有望作为冠心病患者心衰的风险评估工具。与最低的三分位数相比。Ea和运动时Ees的相对变化以及运动时Ea / Ees比率与心衰住院无关。结论稳定CAD和基线HF率低的患者，静息和运动后的Ea / Ees比和Ees与未来的HF住院密切相关。从超声心动图获得的心室-血管耦合显示出有望作为冠心病患者心衰的风险评估工具。