Arterial stiffness: ReviewVentricular–vascular coupling in hypertension: methodological considerations and clinical implicationsSaba, Pier Sergio; Cameli, Matteo; Casalnuovo, Giuseppina; Ciccone, Marco M.; Ganau, Antonello; Maiello, Maria; Modesti, Pietro A.; Muiesan, Maria L.; Novo, Salvatore; Palmiero, Pasquale; Sanna, Giuseppe D.; Scicchitano, Pietro; Pedrinelli, RobertoOn behalf of Gruppo di Studio Ipertensione, Prevenzione e Riabilitazione, Società Italiana di CardiologiaAuthor Information aCardiologia, Azienda Ospedaliero-Universitaria di Sassari, Sassari bDepartment of Cardiovascular Diseases, University of Siena, Siena cCardiovascular Disease Section, Department of Emergency and Organ Transplantation, University of Bari, Bari dAS Department of Cardiology, Brindisi District eDepartment of Clinical and Experimental Medicine, University of Florence, Florence fClinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia gDepartment of Internal Medicine and Cardiovascular Diseases, Palermo hDipartimento di Patologia Chirurgica, Medica, Molecolare e dell’Area Critica, Università di Pisa, Pisa, Italy Correspondence to Dr. Pier Sergio Saba, Cardiologia AOU Sassari, Viale San Pietro, 8, Sassari, Italy Tel: +39 079 229015; e-mail: [email protected] Received 21 October, 2013 Revised 21 April, 2014 Accepted 30 April, 2014 Journal of Cardiovascular Medicine: November 2014 - Volume 15 - Issue 11 - p 773-787 doi: 10.2459/JCM.0000000000000146 Buy Metrics Abstract The present review is addressed to analyse the complex interplay between left ventricle and arterial tree in hypertension. The different methodological approaches to the analysis of ventricular–vascular coupling in the time and frequency domain are discussed. Moreover, the role of hypertension-related changes of arterial structure and function (stiffness and wave reflection) on arterial load and how ventricular–vascular coupling modulates the process of left ventricular adaptation to hypertension are analysed. The different interplay between vascular bed and left ventricle emerges as the pathophysiological basis for the development of the multiple patterns of ventricular structural adaptation in hypertension and provides a pathway for the interpretation of systolic and diastolic functional abnormalities observed in hypertensive patients. Targeting the therapeutic approach to improve ventricular–vascular coupling may have relevant impact on reversing left ventricular hypertrophy and improving systolic and diastolic dysfunction. © 2014 Italian Federation of Cardiology. All rights reserved.