{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:44:53Z","timestamp":1791305093795,"version":"4.3.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Left ventricular (LV) ventricular-arterial coupling (VAC) refers to the ratio of afterload (effective arterial elastance) to contractility (end-systolic elastance) as an integrated marker of cardiac performance. We sought to determine whether the echocardiographic VAC ratio, defined using the ratio of LV end-systolic volume (LVESV) to stroke volume (SV), predicted mortality in the cardiac intensive care unit (CICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Mayo Clinic CICU patients from 2007 and 2018 were included. Ventricular-arterial coupling ratio was calculated as the Teichholz LVESV divided by the SV calculated from LV outflow tract Doppler. The primary outcome was in-hospital mortality and the secondary outcome was all-cause 1-year mortality. A total of 4685 patients were included with a median age of 69 (58, 79) years (37.2% females), with acute coronary syndrome in 54.9% and heart failure in 49.0%. A higher VAC ratio was associated with greater severity of illness, worse echocardiographic findings, and more use of critical care therapies. A total of 329 (7%) patients died during hospitalization. Patients with a higher VAC ratio had higher in-hospital mortality overall and in each admission diagnosis subgroup. After multivariable adjustment, patients with a VAC ratio &amp;gt;2 were at higher risk of in-hospital mortality (adjusted odds ratio 1.63, 95% confidence interval 1.17\u20132.28, P = 0.010). One-year mortality was higher for patients with a higher VAC ratio, especially VAC &amp;gt;2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ventricular-arterial uncoupling was associated with worse outcomes in an unselected CICU cohort. The echocardiographic VAC ratio is a simple non-invasive bedside measure that can be used for risk prediction in the CICU.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuaf038","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:21:54Z","timestamp":1741738914000},"page":"394-402","source":"Crossref","is-referenced-by-count":2,"title":["Left ventricular-arterial coupling and mortality in the cardiac intensive care unit"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2407-7435","authenticated-orcid":false,"given":"Luca","family":"Fazzini","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , 200 First Street SW, Rochester, MN 55905 ,","place":["USA"]},{"name":"Clinical Cardiology Unit, Department of Medical Sciences and Public Health, University of Cagliari , 22 Via S. Avallone, 09127 Cagliari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell R","family":"Padkins","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , 200 First Street SW, Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer","family":"Berg-Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , 200 First Street SW, Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-8867","authenticated-orcid":false,"given":"Mauro","family":"Gori","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Department, Papa Giovanni XXIII Hospital , Piazzo OMS 1, 24127 Bergamo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garvan C","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , 200 First Street SW, Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin B","family":"Hillerson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , 200 First Street SW, Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9560-5138","authenticated-orcid":false,"given":"Guido","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences , University of Pavia"},{"name":"Fondazione IRCCS Policlinico San Matteo Unit of Anesthesia and Intensive Care 27100 Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh N 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