{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:59:24Z","timestamp":1793278764518,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The pulmonary artery pulsatility index (PAPi), calculated from the ratio of the pulmonary artery pulse pressure to right atrial pressure, is a predictor of right ventricular failure after inferior myocardial infarction and left ventricular assist device implantation. Whether PAPi is associated with adverse outcomes across a heterogeneous population is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We examined consecutive patients undergoing right heart catheterization between 2005 and 2016 in a hospital-based cohort. Multivariable Cox models were utilized to examine the association between PAPi and all-cause mortality, major adverse cardiac events, and heart failure hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We studied 8285 individuals (mean age 63 years, 39% women) with median PAPi across quartiles 1.7, 2.8, 4.2, and 8.7, who were followed over a mean follow-up of 6.7\u00b13.3 years. Patients in the lowest PAPi quartile had a 60% greater risk of death compared with the highest quartile (multivariable-adjusted hazard ratio, 1.60 [95% CI, 1.36\u20131.88],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and a higher risk of major adverse cardiac events and heart failure hospitalizations (hazard ratio, 1.80 [95% CI, 1.56\u20132.07],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001 and hazard ratio, 2.08 [95% CI, 1.76\u20132.47],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001, respectively). Of note, patients in quartiles 2 and 3 also had increased risk of cardiovascular events compared with quartile 4 (multivariable\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05 for all).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Compared with the highest PAPi quartile, patients in PAPi quartiles 1 to 3 had a greater risk of all-cause mortality, major adverse cardiac events, and heart failure hospitalizations, with greatest risk observed in the lowest quartile. A low PAPi, even at values higher than previously reported, may serve an important role in identifying high-risk individuals across a broad spectrum of cardiovascular disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.121.009085","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T05:01:04Z","timestamp":1644382864000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Association of Pulmonary Artery Pulsatility Index With Adverse Cardiovascular Events Across a Hospital-Based Sample"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-4199","authenticated-orcid":true,"given":"Emily K.","family":"Zern","sequence":"first","affiliation":[{"name":"Corrigan Minehan Heart Center, Cardiology Division (E.K.Z., S.M.P., C.T.A., E.V.P., M.H.P.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1317-2739","authenticated-orcid":true,"given":"Dongyu","family":"Wang","sequence":"additional","affiliation":[{"name":"CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (D.W., E.E.L., J.K.W., J.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Rambarat","sequence":"additional","affiliation":[{"name":"the Department of Medicine (P.R.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9212-6721","authenticated-orcid":true,"given":"Samuel","family":"Bernard","sequence":"additional","affiliation":[{"name":"Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine (S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha M.","family":"Paniagua","sequence":"additional","affiliation":[{"name":"Corrigan Minehan Heart Center, Cardiology Division (E.K.Z., S.M.P., C.T.A., E.V.P., M.H.P.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6031-3047","authenticated-orcid":true,"given":"Elizabeth E.","family":"Liu","sequence":"additional","affiliation":[{"name":"CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (D.W., E.E.L., J.K.W., J.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-4228","authenticated-orcid":true,"given":"Jenna","family":"McNeill","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care Division (J.M.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1421-4969","authenticated-orcid":true,"given":"Jessica K.","family":"Wang","sequence":"additional","affiliation":[{"name":"CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (D.W., E.E.L., J.K.W., J.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl T.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Corrigan Minehan Heart Center, Cardiology Division (E.K.Z., S.M.P., C.T.A., E.V.P., M.H.P.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene V.","family":"Pomerantsev","sequence":"additional","affiliation":[{"name":"Corrigan Minehan Heart Center, Cardiology Division (E.K.Z., S.M.P., C.T.A., E.V.P., M.H.P.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9264-3243","authenticated-orcid":true,"given":"Michael H.","family":"Picard","sequence":"additional","affiliation":[{"name":"Corrigan Minehan Heart Center, Cardiology Division (E.K.Z., S.M.P., C.T.A., E.V.P., M.H.P.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7987-4768","authenticated-orcid":true,"given":"Jennifer E.","family":"Ho","sequence":"additional","affiliation":[{"name":"CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (D.W., E.E.L., J.K.W., 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