{
  "abstract": "In acute heart failure (AHF), non-invasive ventricular-arterial coupling (VAC) surrogates, including right ventricular-pulmonary arterial (RV-PA) and left ventricular-arterial (LV-Ao) coupling, have emerged as practical bedside indices, but their prognostic significance remains largely unknown systematically. We performed a systematic review and meta-analysis to evaluate the prognostic significance of non-invasive VAC assessment, in patients hospitalized with AHF. Outcomes included all-cause mortality, HF hospitalization, length of hospital stay, use of therapies, the composite of all-cause mortality and HF hospitalization, and in-hospital adverse cardiovascular events. Adjusted hazard ratios (aHRs) and odds ratios (aORs) were pooled using random-effects. Subgroup-analyses were performed according to follow-up duration and left ventricular ejection fraction. Thirty-six studies comprising 36,989 patients were analysed. Twenty-eight studies evaluated RV-PA coupling, predominantly the TAPSE/PASP ratio, and eight evaluated LV-Ao coupling, mainly using non-invasive Ea/Ees estimates. RV-PA uncoupling was independently associated with increased all-cause mortality (aHR 1.90; 95% CI 1.42–2.56; I²=49%), with consistent associations at 12 months (aHR 2.03; 95% CI 1.44–2.85) and long-term follow-up (aHR 1.67; 95% CI 1.06–2.64). Associations with HF hospitalization, hospital stay, and the composite endpoint were directionally consistent but not statistically significant. LV-Ao uncoupling was associated with increased in-hospital adverse cardiovascular events (aOR 1.70; 95% CI 1.29–2.24). Sensitivity analyses confirmed robustness of these findings. RV-PA uncoupling predicts mortality, whereas LV-Ao uncoupling identifies patients at increased risk of in-hospital adverse cardiovascular events, supporting VAC-risk-stratification in AHF and future evaluation of VAC-guided therapeutic strategies.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "name": "Dragos Guz"
    },
    {
      "name": "Daniela Filipescu"
    },
    {
      "name": "Beth Davison"
    },
    {
      "name": "Elena-Laura Antohi"
    },
    {
      "name": "Andrew P Ambrosy"
    },
    {
      "name": "Serban Mihaileanu"
    },
    {
      "name": "Oliviana Geavlete"
    },
    {
      "name": "Sean P Collins"
    },
    {
      "name": "Razvan Radu"
    },
    {
      "name": "Marianna Adamo"
    },
    {
      "name": "Nicolas Girerd"
    },
    {
      "name": "Radu Filipescu"
    },
    {
      "name": "Luca Monzo"
    },
    {
      "name": "Jan Biegus"
    },
    {
      "name": "Gad Cotter"
    },
    {
      "name": "Ovidiu Chioncel"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bjh48xngbjcpp.bib",
  "cited_by": 0,
  "doi": "10.1007/s10741-026-10680-w",
  "fulltext_url": null,
  "id": "bjh48xngbjcpp",
  "issns": [
    "1382-4147",
    "1573-7322"
  ],
  "landing_url": "https://hal.univ-lorraine.fr/hal-05789056v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2705|Cardiovascular Function and Risk Factors"
    ]
  ],
  "openalex": "W7220680809",
  "pdf_url": "https://hal.univ-lorraine.fr/hal-05789056/document",
  "pmcid": null,
  "pmid": "42837026",
  "published": "2026-10-06",
  "publisher": "Springer Verlag",
  "ris": "https://research.draconitic.com/paper/bjh48xngbjcpp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:52Z",
      "native_id": "hal-05789056",
      "source": "hal",
      "url": "https://hal.univ-lorraine.fr/hal-05789056v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiovascular Function and Risk Factors",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Ventriculo-arterial coupling in acute heart failure: prognostic and therapeutic insights - a systematic review and meta-analysis of multivariable-adjusted data",
  "title_text": "Ventriculo-arterial coupling in acute heart failure: prognostic and therapeutic insights - a systematic review and meta-analysis of multivariable-adjusted data",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:52Z",
  "url": "https://research.draconitic.com/paper/bjh48xngbjcpp",
  "venue": "Heart Failure Reviews",
  "versions": []
}