{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T09:42:02Z","timestamp":1775641322479,"version":"3.50.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Decoupling between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure is an index of pulmonary vascular damage. This study assessed the impact of decoupling on right heart function and hemocompatibility\u2010related adverse events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In this prospective study, patients underwent invasive hemodynamic tests following left ventricular assist device implantation. Decoupling was defined as a difference of &gt;5\u00a0mm\u00a0Hg between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure. Among 92 patients with left ventricular assist devices (median age, 61\u00a0years; 57% male), 44 patients (48%) had decoupling. Right heart function and size by echocardiographic assessment worsened during a 1\u2010year observational period in the decoupling group as compared with the control group (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). The decoupling group had significantly lower 1\u2010year freedom from any hemocompatibility\u2010related adverse events (49% versus 79%;\n              <jats:italic>P<\/jats:italic>\n              =0.005), as well as a higher hemocompatibility score (2.14 versus 0.67;\n              <jats:italic>P<\/jats:italic>\n              =0.004). The scoring system depicts the severity of hemocompatibility\u2010related adverse events using 4 escalating tiers. Increased tier I scores (1\u20132 gastrointestinal bleedings or medically managed pump thrombosis;\n              <jats:italic>P<\/jats:italic>\n              =0.027) and tier IIIB scores (disabling stroke or hemocompatibility\u2010related adverse event\u2013related death;\n              <jats:italic>P<\/jats:italic>\n              =0.041) occurred more frequently in the decoupling group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The presence of decoupling between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure was associated with worsening of right heart function and hemocompatibility\u2010related adverse events in patients with left ventricular assist devices.<\/jats:p>\n          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