Related Experiment Video
Updated: Jan 7, 2026
08:12
Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
10.5K
Dynamic Changes in Right Ventricular-Pulmonary Arterial Coupling During Acute Heart Failure Hospitalization:
Vasileios Anastasiou1, Evdoxia Stavropoulou1, Emmanouela Peteinidou1
11st Department of Cardiology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
The American Journal of Cardiology
|December 30, 2025
Summary
Persistent right ventricular-pulmonary arterial uncoupling in acute heart failure patients predicts worse outcomes. Patients with uncoupling at discharge had significantly lower survival rates, highlighting its prognostic importance.
Area of Science:
- Cardiology
- Pulmonary Hypertension
- Heart Failure
Background:
- Right ventricular-pulmonary arterial (RV-PA) uncoupling is a key predictor of outcomes in heart failure (HF).
- RV-PA uncoupling can change significantly during hospitalization for acute HF.
Purpose of the Study:
- To investigate dynamic changes in RV-PA uncoupling during acute HF hospitalization.
- To determine the prognostic significance of these changes.
Main Methods:
- Echocardiography measured tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) ratio on admission and discharge in 490 acute HF patients.
- RV-PA uncoupling defined as TAPSE/PASP <0.36 mm/mmHg.
- Patients categorized into RV-PA coupling, normalized RV-PA uncoupling, and persistent RV-PA uncoupling groups.
Main Results:
- Persistent RV-PA uncoupling was observed in 30.8% of patients.
- Persistent RV-PA uncoupling was independently associated with a higher risk of all-cause mortality and HF rehospitalization (HR 2.78).
- Event-free survival at 1 year was significantly lower for persistent RV-PA uncoupling (37.1%) compared to other groups.
Conclusions:
- Persistence of RV-PA uncoupling at discharge in hospitalized acute HF patients is linked to worse 1-year event-free survival.
- Persistent RV-PA uncoupling provides incremental prognostic value beyond baseline risk factors.
- Monitoring RV-PA coupling status at discharge may aid in risk stratification for acute HF patients.
More Related Videos
Related Concept Videos
01:29Heart Failure II: Pathophysiology
663
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
663
01:30Heart Failure V: Medical Management
196
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
196
01:26Heart Failure III: Clinical Manifestations
436
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
436
01:20Mitral Regurgitation I: Introduction
364
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
364
01:17Pathophysiology of Heart Failure
2.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.7K
01:22Mitral Stenosis I: Introduction
384
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
384