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Endothelial dysfunction is a plausible candidate because it has been associated with heart failure. This study aims to investigate the association between MEE and endothelium\u2010dependent vasodilation, among drug-na\u00efve hypertensive individuals. 198 Drug-na\u00efve hypertensive individuals participating in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study were included. All participants underwent to an oral glucose tolerance test and to an echocardiogram for myocardial LVM-normalized mechano-energetic efficiency (MEEi) measurement. Endothelial-dependent and endothelial-independent vasodilatation were measured by strain-gauge plethysmography during intra-arterial infusion of acetylcholine and sodium nitroprusside, respectively. A multivariate linear regression analysis was conducted to investigate the independent association between maximal endothelial-dependent vasodilation and MEEi. Maximal ACh-stimulated forearm blood flow (FBF) was associated to decreased myocardial MEEi (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.205, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) independently of well\u2010established cardiovascular risk factors including age, sex, BMI, waist circumference, smoking status, total and HDL cholesterol, triglycerides, hsCRP, glucose tolerance status, and HOMA-IR index of insulin resistance. Conversely, no association was observed between SNP-stimulated vasodilation and MEEi. Endothelium-mediated vasodilation may contribute to reduce myocardial MEEi independently of several potential confounders. Because diminished myocardial MEE has been previously associated with incident heart failure, a non-invasive assessment of myocardial MEEi may improve the identification of individuals at higher cardiovascular risk who may benefit from the initiation of pharmacological treatments ameliorating the endothelial dysfunction.<\/jats:p>","DOI":"10.1007\/s11739-023-03402-9","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T13:03:11Z","timestamp":1695819791000},"page":"2223-2230","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Endothelial dysfunction is associated with reduced myocardial mechano-energetic efficiency in drug-na\u00efve hypertensive individuals"],"prefix":"10.1007","volume":"18","author":[{"given":"Chiara M. 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