{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:51:48Z","timestamp":1793836308700,"version":"4.6.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["ICMx"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-induction hypotension (PIH) is associated with acute perioperative organ injury. We quantified the added value of echocardiographic parameters and ventriculo-arterial coupling (VAC)-related variables for the prediction of PIH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective observational cohort study conducted between July 2023 and November 2024 enrolled adults undergoing elective non-cardiac surgery. The ventriculo-arterial coupling index (\n                      <jats:italic>E<\/jats:italic>\n                      <jats:sub>a<\/jats:sub>\n                      \/\n                      <jats:italic>E<\/jats:italic>\n                      <jats:sub>es<\/jats:sub>\n                      ) was derived pre-operatively using transthoracic echocardiography combined with non-invasive blood pressure measurements. PIH was defined as the first occurrence of mean arterial pressure\u2009&lt;\u200965\u00a0mmHg between anaesthesia induction and surgical incision. Predictors were analysed using a generalised additive model to account for potential non-linear associations. Incremental prognostic value was assessed using the fraction of new information (FNI), a reclassification-based metric, and changes in the area under the receiver operating characteristic curve (AUC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PIH occurred in 161\/405 patients (39.8%). An\n                      <jats:italic>E<\/jats:italic>\n                      <jats:sub>a<\/jats:sub>\n                      \/\n                      <jats:italic>E<\/jats:italic>\n                      <jats:sub>es<\/jats:sub>\n                      ratio\u2009&gt;\u20091 was associated with PIH (OR 2.95; 95% CI 1.08\u20138.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). The clinical model showed an AUC of 0.720 (95% CI 0.669\u20130.771). The addition of echocardiographic parameters increased the AUC to 0.768 (95% CI 0.720\u20130.816; Holm-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018) and provided 37% FNI (Holm-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.199). The incorporation of VAC-related variables further increased the AUC to 0.785 (95% CI 0.739\u20130.831; Holm-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and yielded 46% FNI (Holm-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030). Compared with the clinical\u2013echocardiographic model, incorporation of VAC-related variables provided an additional 14% FNI (Holm-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018) without a statistically significant AUC increase (0.017; 95% CI \u22120.004\u20130.039; Holm-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.199).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      PIH was common and was independently associated with impaired VAC, as reflected by an\n                      <jats:italic>E<\/jats:italic>\n                      <jats:sub>a<\/jats:sub>\n                      \/\n                      <jats:italic>E<\/jats:italic>\n                      <jats:sub>es<\/jats:sub>\n                      ratio\u2009&gt;\u20091. Incorporation of echocardiographic parameters improved the discriminatory performance of a clinical prediction model, and the further addition of VAC-related variables provided meaningful improvement in risk reclassification, despite only modest gains in overall discrimination.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40635-026-00899-0","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T03:23:25Z","timestamp":1776741805000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictive value of ventriculo-arterial coupling for hypotension after induction of anaesthesia: a prospective observational cohort study"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-1140","authenticated-orcid":false,"given":"Hong Chinh","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3604-3375","authenticated-orcid":false,"given":"Chau Bich Ha","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5639-3355","authenticated-orcid":false,"given":"Thi Thu Trang","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6251-6499","authenticated-orcid":false,"given":"Ton Ngoc Vu","family":"Phan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2971-2584","authenticated-orcid":false,"given":"Duc Nam","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1146-965X","authenticated-orcid":false,"given":"Trung Hieu","family":"Duong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-0900","authenticated-orcid":false,"given":"Tran Huy Nhat","family":"Phung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4281-4929","authenticated-orcid":false,"given":"Huu Khanh Trinh","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3827-5010","authenticated-orcid":false,"given":"Yvon L. 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