Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis

Carolyn L. Lekavich, Debra J. Barksdale, Jia Rong Wu, Virginia Neelon, Jamie Crandell, Eric J. Velazquez

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background Evidence continues to demonstrate increasing prevalence, cost, and mortality implications of heart failure with preserved ejection fraction (HFpEF), but clearly defined parameters that distinguish between control subjects and HFpEF have not been established. Objectives This study was designed to detect differences in markers associated with Ventricular-arterial coupling and HFpEF when comparing matched case and control groups. Methods A study cohort of case (incident patients with HFpEF; n = 155) and matched control (patients with no prior heart failure; n = 155) groups was retrospectively identified. Matching criteria included race, sex, age, and date of echocardiography (within 1 year). Physiologic and echocardiographic markers were collected from previously acquired transthoracic echocardiograms. These echocardiographic images were reanalyzed, and measures of ventricular-arterial coupling were calculated. Using conditional logistic regression and controlling for covariates, models were fitted to detect differences in HFpEF markers between case and control subjects. Results Statistically significant differences in markers that reflect ventricular elastance (Ees; P =.007) and left atrial diameter (LAdiam; P =.04) were detected when comparing the case and control groups. Conditional logistic regression analyses suggested a 40% higher odds of being in the case group with every 1-unit increase in Ees (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.10–1.79) and a 2.92 times higher odds of being in the case group for every 1 cm increase in LAdiam (OR 2.92, 95% CI 1.064–7.994). Conclusions Ees and LAdiam are easily measurable echocardiographic markers that may have a role in identifying and tracking the progression toward incident HFpEF without increasing cost or risk to the patient. Prospective studies are indicated to explore the use of Ees and LAdiam as predictors of impending HFpEF.

Original languageEnglish
Pages (from-to)659-665
Number of pages7
JournalJournal of Cardiac Failure
Issue number9
StatePublished - Sep 2017

Bibliographical note

Publisher Copyright:
© 2017 Elsevier Inc.


  • Heart failure with preserved ejection fraction (HFpEF)
  • diastolic heart failure
  • matched case-control
  • ventricular-arterial coupling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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