{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:44:56Z","timestamp":1791305096155,"version":"4.3.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Assessment of right ventricular\u2013pulmonary artery coupling plays a crucial role in risk stratification, monitoring efficacy, and predicting outcomes in chronic heart failure patients. However, data in acute heart failure (AHF) are still lacking.<\/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                      This multicenter observational study includes 425 patients with AHF: 248 with reduced left ventricular ejection fraction (&lt;50%) and 177 with preserved left ventricular ejection fraction (\u226550%). Pulmonary artery systolic pressure (PASP), tricuspid annular plane systolic excursion (TAPSE), longitudinal 2\u2010dimensional strain of right ventricular (RV) free wall, and the RV end\u2010diastolic diameter were measured by echocardiography. TAPSE\/PASP and longitudinal 2\u2010dimensional strain of RV free wall\/PASP ratios were calculated as noninvasive surrogates of right ventricular\u2013pulmonary artery coupling. The end point was a composite of all\u2010cause death\/HF\u2010related hospitalizations assessed at 180\u2009days. At 180\u2009days, 197 patients (46.4%) reached the end point. After multivariable adjustment for RV end\u2010diastolic diameter, E\/e\u2032 ratio, left ventricular ejection fraction, and natriuretic peptides, although both TAPSE\/PASP (hazard ratio [HR], 0.49 [95% CI, 0.25\u20130.27];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.042) and longitudinal 2\u2010dimensional strain of RV free wall\/PASP (HR, 0.30 [95% CI, 0.13\u20130.67];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.004) had a statistically significant association with the end point, and longitudinal 2\u2010dimensional strain of RV free wall\/PASP better discriminated between patients with and without events compared with TAPSE\/PASP (area under the curve, 0.70 versus 0.66;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.0041). Interestingly, the superiority of longitudinal 2\u2010dimensional strain of RV free wall\/PASP over the TAPSE\/PASP ratio was more evident in patients with AHF with preserved ejection fraction (area under the curve, 0.72 versus 0.64;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) than in those with AHF with reduced ejection fraction (AUC, 0.67 versus 0.64;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =NS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients with AHF, both TAPSE\/PASP and longitudinal 2\u2010dimensional strain of RV free wall\/PASP are independent predictor of prognosis. However, longitudinal 2\u2010dimensional strain of RV free wall\/PASP showed a superior discriminator capability in identifying patients with events, mainly in the AHF with preserved ejection fraction subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique Identifier: NCT02638142.\n                    <\/jats:p>\n                  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Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5473-227X","authenticated-orcid":false,"given":"Nicola Riccardo","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Pisa University Heart Failure Laboratory","place":["Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2841-1429","authenticated-orcid":false,"given":"Gaetano","family":"Ruocco","sequence":"additional","affiliation":[{"name":"Hospital Veris delle Fonti Cardiology Unit ASL","place":["Lecce, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6211-4482","authenticated-orcid":false,"given":"Paolo","family":"Severino","sequence":"additional","affiliation":[{"name":"Anesthesiological. and Cardiovascular Sciences, Sapienza University of Rome","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3540-4983","authenticated-orcid":false,"given":"Dario","family":"Vizza","sequence":"additional","affiliation":[{"name":"Anesthesiological. and Cardiovascular Sciences, Sapienza University of Rome","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Carbonara","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit of Bari Institute","place":["Bari, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Passantino","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit of Bari Institute","place":["Bari, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9296-4397","authenticated-orcid":false,"given":"Erberto","family":"Carluccio","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiovascular 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