{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:05:26Z","timestamp":1792209926081,"version":"4.4.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"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":[[2023,9,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To investigate the prognostic value of the right ventricle-to-pulmonary artery (RV-PA) coupling in patients with either transthyretin (ATTR) or immunoglobulin light-chain (AL) cardiac amyloidosis (CA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Overall, 283 patients with CA from 3 Italian high-volume centres were included (median age 76 years; 63% males; 53% with ATTR-CA, 47% with AL-CA). The RV-PA coupling was evaluated by using the tricuspid annular plane systolic excursion\/pulmonary artery systolic pressure (TAPSE\/PASP) ratio. The median value of TAPSE\/PASP was 0.45 (0.33\u20130.63) mm\/mmHg. Patients with a TAPSE\/PASP ratio &amp;lt;0.45 were older, had lower systolic blood pressure, more severe symptoms, higher cardiac troponin and N-terminal pro-B-type natriuretic peptide levels, greater left ventricular (LV) thickness, and worse LV systolic and diastolic function. A TAPSE\/PASP ratio &amp;lt;0.45 was independently associated with a higher risk of all-cause death or heart failure (HF) hospitalization [hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.32\u20132.96; P = 0.001] and all-cause death (HR 2.18, 95% CI 1.31\u20133.62; P = 0.003). The TAPSE\/PASP ratio reclassified the risk of both endpoints [net reclassification index 0.46 (95% CI 0.18\u20130.74) P = 0.001 and 0.49 (0.22\u20130.77) P &amp;lt; 0.001, respectively], while TAPSE or PASP alone did not (all P &amp;gt; 0.05). The prognostic impact of the TAPSE\/PASP ratio was significant both in AL-CA patients (HR for the composite endpoint 2.47, 95% CI 1.58\u20133.85; P &amp;lt; 0.001) and in ATTR-CA (HR 1.81, 95% CI 1.11\u20132.95; P = 0.017). The receiver operating characteristic curve showed that the optimal cut-off for predicting prognosis was 0.47 mm\/mmHg.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with CA, RV-PA coupling predicted the risk of mortality or HF hospitalization. The TAPSE\/PASP ratio was more effective than TAPSE or PASP in predicting prognosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead145","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T20:22:09Z","timestamp":1687983729000},"page":"1405-1414","source":"Crossref","is-referenced-by-count":33,"title":["Right ventricular to pulmonary artery coupling and outcome in patients with cardiac amyloidosis"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7584-2857","authenticated-orcid":false,"given":"Daniela","family":"Tomasoni","sequence":"first","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-1815","authenticated-orcid":false,"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldostefano","family":"Porcari","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste , Trieste , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-9519","authenticated-orcid":false,"given":"Alberto","family":"Aimo","sequence":"additional","affiliation":[{"name":"Health Science Interdisciplinary Center, Scuola Superiore Sant\u2019Anna , Pisa , Italy"},{"name":"Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio , Pisa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Battista","family":"Bonfioli","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-2328","authenticated-orcid":false,"given":"Vincenzo","family":"Castiglione","sequence":"additional","affiliation":[{"name":"Health Science Interdisciplinary Center, Scuola Superiore Sant\u2019Anna , Pisa , Italy"},{"name":"Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio , Pisa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Franzini","sequence":"additional","affiliation":[{"name":"Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Universit\u00e0 di Pisa , Pisa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo Maria","family":"Inciardi","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Khalil","sequence":"additional","affiliation":[{"name":"Health Science Interdisciplinary Center, Scuola Superiore Sant\u2019Anna , Pisa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Mario","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2633-1695","authenticated-orcid":false,"given":"Laura","family":"Lupi","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"Nardi","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Oriecuia","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia , Brescia , Italy"},{"name":"Department of Molecular and Translational Medicine, University of Brescia , Brescia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-7871","authenticated-orcid":false,"given":"Matteo","family":"Pagnesi","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Panichella","sequence":"additional","affiliation":[{"name":"Health Science Interdisciplinary 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Vergaro","sequence":"additional","affiliation":[{"name":"Health Science Interdisciplinary Center, Scuola Superiore Sant\u2019Anna , Pisa , Italy"},{"name":"Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio , Pisa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1022-3131","authenticated-orcid":false,"given":"Marco","family":"Merlo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste , Trieste , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste , Trieste , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Emdin","sequence":"additional","affiliation":[{"name":"Health Science Interdisciplinary Center, Scuola Superiore Sant\u2019Anna , Pisa , Italy"},{"name":"Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio , Pisa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Piazzale Spedali Civili, Brescia 25123 , 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