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Recently, a wealth of observational data has arisen, outlining its prognostic value in heart failure (HF) patients. To systematically appraise and quantitatively synthesize the evidence of the prognostic value of TAPSE\/PASP ratio in left-sided HF regardless of etiology or left ventricular ejection fraction. A systematic literature review was conducted in electronic databases to identify studies reporting the association of TAPSE\/PASP ratio with outcomes in patients with HF and, when appropriate, a random-effects meta-analysis was conducted to quantify the unadjusted and adjusted hazard ratios [(a)HRs] for all-cause death and the composite outcome of all-cause death or HF hospitalization. Eighteen studies were deemed eligible encompassing 8,699 HF patients. The applied cut-off value for RV-PA uncoupling varied substantially from 0.27 to 0.58 mm\/mmHg, and in most studies values lower than the applied cutoff conveyed dismal prognosis. Eleven studies reported appropriate data for meta-analysis. TAPSE\/PASP reduction by 1 mm\/mmHg was independently associated with all-cause death (pooled aHR=1.32 [1.06-1.65]; p=0.01; I<jats:sup>2<\/jats:sup>=56%) and the composite outcome (pooled aHR=3.48 [1.67-7.25]; p&lt;0.001; I<jats:sup>2<\/jats:sup>=0%). When a TAPSE\/PASP cutoff value of 0.36 mm\/mmHg was applied it yielded independent association with all-cause death (pooled aHR=2.84 [2.22-3.64]; p&lt;0.001; I<jats:sup>2<\/jats:sup>=82%). RV-PA coupling assessed by echocardiographic TAPSE\/PASP ratio appears to be an independent outcome predictor for HF patients.\n<\/jats:p>","DOI":"10.1007\/s10741-023-10341-2","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T11:03:31Z","timestamp":1693220611000},"page":"13-26","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["The prognostic impact of right ventricular-pulmonary arterial coupling in heart failure: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"29","author":[{"given":"Vasileios","family":"Anastasiou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas S.","family":"Papazoglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios V.","family":"Moysidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stylianos","family":"Daios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Barmpagiannos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gossios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios K.","family":"Efthimiadis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Karamitsos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Ziakas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-6718","authenticated-orcid":false,"given":"Vasileios","family":"Kamperidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"key":"10341_CR1","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1161\/CIRCHEARTFAILURE.112.000161","volume":"6","author":"L Tavazzi","year":"2013","unstructured":"Tavazzi L, Senni M, Metra M, Gorini M, Cacciatore G, Chinaglia A, Di Lenarda A, Mortara A, Oliva F, Maggioni AP (2013) Multicenter prospective observational study on acute and chronic heart failure: one-year follow-up results of IN-HF (Italian Network on Heart failure) outcome registry. 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