Background:Evaluation of end-systolic pressure volume relations and their slope, end-systolic elastance(Ees), has proven useful to examine ventricular and vascular interactions since Ees is a major determinant of LV systolic performance Effective arterial elastance (Ea), a ratio of end systolic blood pressure and stroke volume, provides a reliable estimate of aortic impedance. Since it shares the same dimensional units as Ees, the ratio of Ea to Ees has been used to assess the characteristic of ventricular-vascular coupling. The ratio approaching unity is a marker of an uncoupled ventricle and vasculature, an event that is associated with poor circulatory efficiency. Strain and strain rate are considered an index of left ventricular systolic function even in patients with normal ejection fraction. So, we investigate the contribution of the ratio of Ea to Ees, a measure of mechanical contractile efficiency, with the expression of strain and strain rate, a early marker of ventricular systolic dysfunction. Methods: The study population consisted of 125 essential hypertension patients, 54 men and 71 women. Stroke volume was obtained by difference of LV end diastolic volume and LV end systolic volume.End-systolic pressure (ESP) was approximated by (2xSBP + DBP)/3. This noninvasive assessment of ESP accurately predicts LV pressure-volume loop measurements of ESP. The following indexes were calculated: 1) arterial ventricular coupling index (EaI/ELVI) = ESVI/SVI; 2) EaI = ESP/SVI; and 3) LV systolic elastance index (ELVI) = ESP/ESVI. Results There was a significant negative correlation between ventricular vascualar coupling and systolic strain (r = 0.31, p = 0.021) after controlling for age, sex, systolic BP. Furthermore, there is a significant positive correlation between ventricular vascular coupling and LVMI (r = 0.20, p = 0.004) after controlling for age, sex, systolic BP. Conclusion: Ventricular-vascular coupling helps to predict the early left ventricular systolic dysfunction and LV hypertrophy, independent of alteration in blood pressure