{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:48:42Z","timestamp":1793148522625,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Right ventricular functional adaptation to afterload is a major determinant of outcome in pulmonary arterial hypertension (PAH). We aimed to investigate if right ventricular-pulmonary artery (PA) coupling evaluated by the ratio of tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure (sPAP) improves risk assessment scores for survival prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A total of 677 consecutive patients with PAH (55% idiopathic) were prospectively enrolled with follow-up clinical, right heart catheterization, and echocardiographic evaluations within 12 months (interquartile range, 180\u2013344 days) after initiation of targeted therapies in 11 Italian centers. European Society of Cardiology\/European Respiratory Society guidelines-derived risk scores and REVEAL 2.0 (US Registry to Evaluate Early and Long-Term PAH Disease Management 2.0) risk scores were collected at baseline and follow-up. 254 consecutive patients with PAH retrospectively enrolled in a German reference center served as a validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A low-risk status at a median of 3.7 years (interquartile range, 1.2\u20136.8) follow-up was significantly associated with each unit (0.1 mm\/mm\u2009Hg) increase in TAPSE\/sPAP under targeted therapies (European Society of Cardiology\/European Respiratory Society score: odds ratio, 1.78;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u22640.001; REVEAL 2.0 score: odds ratio, 1.43;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u22640.001). At follow-up, the TAPSE\/sPAP ratio increased the prognostic information of each risk stratum of the European Society of Cardiology\/European Respiratory Society risk score, except the highest risk stratum, with 0.5 mm\/mm\u2009Hg, 0.35 mm\/mm\u2009Hg, and 0.30 mm\/mm\u2009Hg, from the lowest to the intermediate-high risk score, identified as the best cutoff value. TAPSE\/sPAP ratio increased the prognostic information of the REVEAL 2.0 score at follow-up, with 0.35 mm\/mm\u2009Hg identified as the best cutoff value to discriminate within a score of 5 to 8, with no added value for scores &lt;5 and &gt;8. These results were confirmed in the validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Assessment of right ventricular-PA coupling by the TAPSE\/sPAP ratio in PAH improves risk assessment scores except in the lowest or most advanced stage of the disease<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.124.012518","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T09:00:15Z","timestamp":1758099615000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["TAPSE\/sPAP Ratio to Improve Risk Assessment in Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7887-5961","authenticated-orcid":true,"given":"Roberto","family":"Badagliacca","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Respiratory Sciences\u2013Sapienza University of Rome, Italy (R.B., D.F., G.M., A.M., S.P., T.R., C.D.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5557-623X","authenticated-orcid":true,"given":"Khodr","family":"Tello","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Germany (K.T., Z.A.R., M.R., A.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5729-1038","authenticated-orcid":true,"given":"Michele","family":"D\u2019Alto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Monaldi Hospital\u2013University L. Vanvitelli, Naples, Italy (M.D.A., P.A., E.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1858-1152","authenticated-orcid":true,"given":"Stefano","family":"Ghio","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico S Matteo, Pavia, Italy (S.G., A.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Argiento","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Monaldi Hospital\u2013University L. Vanvitelli, Naples, Italy (M.D.A., P.A., E.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9610-7408","authenticated-orcid":true,"given":"Natale Daniele","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Foggia, Italy (N.D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Casamassima","sequence":"additional","affiliation":[{"name":"Department of Cardiology, F. 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