Association Between Ventricular-Arterial Coupling and C-Reactive Protein in Patients at Risk for Heart Failure
Clinical Snapshot
PICO Framework
| P — Population | 112 hypertensive patients at risk for heart failure |
| I — Intervention | High-sensitivity C-reactive protein (hs-CRP) levels |
| C — Comparator | Different levels of hs-CRP (continuous and categorical) |
| O — Outcomes | Ventricular-arterial coupling assessed by arterial elastance to left ventricular end-systolic elastance ratio (Ea/Ees) |
Bottom Line
This cross-sectional study of 112 hypertensive patients demonstrates an independent association between elevated high-sensitivity C-reactive protein and impaired ventricular-arterial coupling, as measured by the Ea/Ees ratio. The moderate effect size (β=0.27, P=0.003) suggests that inflammatory markers may provide additional prognostic information in patients at risk for heart failure. However, the small sample size, cross-sectional design, and Japanese population limit the strength of conclusions. While hs-CRP is readily available in Australian practice, routine VAC assessment requires specialised echocardiographic expertise. These findings support the biological plausibility of inflammation contributing to cardiac-vascular dysfunction but require validation in larger, longitudinal studies before influencing clinical practice. The results may inform risk stratification discussions in hypertensive patients but should not yet guide therapeutic decisions.
Key Findings
P Value: P = 0.003
Effect Size: Standardised beta coefficient = 0.27
Primary Outcome: Independent association between categorical hs-CRP and ventricular-arterial coupling (Ea/Ees ratio)
Nnt Or Sensitivity: Not applicable for association study
Confidence Interval: Not reported
Clinical Application
hs-CRP readily available through Medicare-subsidised pathology; VAC assessment requires specialised echocardiographic expertise hs-CRP testing covered under Medicare item 66596; aligns with RACGP guidelines for cardiovascular risk assessment in hypertensive patients Hypertensive patients at risk for heart failure, particularly those undergoing cardiovascular risk stratification
Abstract
BACKGROUND: Although ventricular-arterial coupling (VAC) and C-reactive protein (CRP) are associated with the pathogenesis of heart failure (HF), their association in patients at risk of HF remains unclear. METHODS AND RESULTS: VAC was assessed by arterial elastance (Ea) to left ventricular endsystolic elastance (Ees) ratio (Ea/Ees) using the noninvasive single-beat method in 112 hypertensive patients. Log-transformed high-sensitivity CRP (hs-CRP) and categorical hs-CRP were associated with Ea/Ees on univariate analysis. Categorical hs-CRP was independently associated with Ea/Ees after adjusting for atherosclerotic risk factors, cardiac function and vascular function (β=0.27, P=0.003). CONCLUSIONS: hs-CRP was independently associated with VAC assessed by Ea/Ees in patients at risk of HF.
References
- 1.Takei, Y., Tomiyama, H., Yamashina, A., Higashi, Y., & Satomi, K. (2026). Association Between Ventricular-Arterial Coupling and C-Reactive Protein in Patients at Risk for Heart Failure. Circulation Journal, Advance online publication. https://doi.org/10.1253/circj.CJ-25-1179
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