Ventricular-Arterial Uncoupling in Mild to Moderate COVID-19 Pneumonia: Role of A Novel Ventricular-Vascular Coupling Index

Objective The physiological interaction between the left ventricle (LV) and the arterial system, known as ventricular-arterial coupling (VAC), plays a crucial role in optimizing cardiac work and overall cardiovascular performance. This study aims to investigate VAC by analyzing the ratio of the arterial velocity pulse index (AVI) to LV global longitudinal strain (GLS), in patients with mild to moderate COVID-19. Methods This study included 180 controls and 154 patients with mild to moderate COVID-19. We compared laboratory indicators, left ventricular ejection fraction (LVEF), TDI e’, effective arterial elasticity (Ea), left ventricular end-systolic elasticity (Ees), ventricular-arterial coupling index (VVI), AVI and GLS between the two groups. Correlations between AVI/GLS and clinical/laboratory indicators were assessed. Results The values of GLS _ww , GLSepi were significantly lower in patients with COVID-19 than controls ( p  < 0.05). However, there were no significant differences in GLS _mid and GLS _endo between the two groups ( p  > 0.05). The AVI/GLS ratio was significantly lower in the COVID-19 group than in controls ( p  < 0.05). AVI/GLS ratio was negatively correlated with age and systolic blood pressure (SBP), and positively correlated with left ventricular ejection fraction (LVEF) ( p  < 0.05). Age, SBP, and LVEF were identified as independent predictors of AVI/GLS. The area under the curve (AUC) for AVI/GLS ratio in diagnosing mild to moderate COVID-19 was 0.583, with a sensitivity of 78.6%. Conclusion The AVI/GLS ratio could serve as a valuable tool for detecting altered ventricular-arterial coupling in patients mild to moderate COVID-19.