Heart failure with preserved ejection fraction (HFPEF) is a syndrome that frequently occurs in older people and
patients with cardiovascular risk factors, particularly hypertension. This syndrome is not a specific disease process,
whereas is associated with high morbidity and mortality in patients with heart failure with reduced ejection fraction
(HFREF) as well. Therefore, a “one size fits all” diagnosis strategy is unlikely to operate for patients with HFPEF.
Assessment of left atrial (LA)-left ventricular (LV)-arterial coupling seems to have a clinical impact on hypertensive
patients, because HF signs and symptoms have been found to be significantly related to inappropriate LA-LV interaction
during diastole and LV-arterial interaction during systole. Two-dimensional speckle tracking echocardiography (2DSTE)
is a new tool that may have a role in earlier detecting the impaired LA, LV, and arterial function in asymptomatic patients.
This review explored the impact of LA-LV-arterial coupling in understanding the pathophysiology of hypertension as a
road to HFPEF, and the possibilities of clinical application by using 2DSTE.