{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:14:36Z","timestamp":1790309676636,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Grant-in-Aid for Scientific Research","award":["23K07484"],"award-info":[{"award-number":["23K07484"]}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Higher left ventricular (LV) ejection fraction (EF) is related to unfavourable prognosis in patients with heart failure (HF) with preserved ejection fraction (HFpEF). The cause of this finding needs to be haemodynamically explained. Thus, we investigated this crucial issue from the perspective of LV\u2013arterial (A) and right ventricular (RV)\u2013pulmonary arterial (PA) coupling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Study patients were derived from our prospective cohort study of patients hospitalized due to acute decompensated HF and LVEF &amp;gt; 40%. We divided the 255 patients into three groups: HF with mildly reduced EF (HFmrEF), HFpEF with 50% \u2264 LVEF &amp;lt; 60%, and HFpEF with LVEF \u2265 60%. We compared LV end-systolic elastance (Ees), effective arterial elastance (Ea), and Ees\/Ea as a representative of LV\u2013A coupling among groups and compared the ratio of tricuspid annular plane excursion to peak pulmonary arterial systolic pressure (TAPSE\/PASP) as a representative of RV\u2013PA coupling. All-cause death and readmission due to HF-free survival was worse in the group with a higher LVEF range. Ees\/Ea was greater in HFpEF patients with LVEF \u2265 60% (2.12 \u00b1 0.57) than in those with 50% \u2264 LVEF &amp;lt; 60% (1.20 \u00b1 0.14) and those with HFmrEF (0.82 \u00b1 0.09) (P &amp;lt; 0.001). PASP was increased in the groups with higher LVEF; however, TAPSE\/PASP did not differ among groups (n = 168, P = 0.17). In a multivariate Cox proportional hazard model, TAPSE\/PASP but not PASP was significantly related to event-free survival independent of LVEF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>HFpEF patients with higher LVEF have unfavourable prognosis and distinctive LV\u2013A coupling: Ees\/Ea is elevated up to 2.0 or more. Impaired RV\u2013PA coupling also worsens prognosis in such patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration<\/jats:title>\n                  <jats:p>URL: https:\/\/www.umin.ac.jp\/ctr\/index.htm Unique identifier: UMIN000017725.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeae033","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T12:18:02Z","timestamp":1706530682000},"page":"774-781","source":"Crossref","is-referenced-by-count":13,"title":["Distinctive left ventricular\u2013arterial and right ventricular\u2013pulmonary arterial coupling observed in patients with heart failure and a higher left ventricular ejection fraction range"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1934-6864","authenticated-orcid":false,"given":"Nobuyuki","family":"Ohte","sequence":"first","affiliation":[{"name":"Department of 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City University Graduate School of Medical Sciences , 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EASY HFpEF investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Ohte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Kikuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Iwahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Kinugasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Dohi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Takase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumiko","family":"Masai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuji","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Okumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Hachiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Kitada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyoaki","family":"Murohara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Iwano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsushige","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotsugu","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenya","family":"Kusunose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Iwataki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiyo","family":"Sugiura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"2024053023520728100_jeae033-B1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.cardfail.2021.01.022","article-title":"Universal 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