ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2025
Prognostic Value of Echocardiographic Coupling Metrics in Systemic Sclerosis-Associated Pulmonary Vascular Disease.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The prognostic role of right ventricular-pulmonary arterial coupling in aortic stenosis patients undergoing TAVR: a systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- Validation of Tricuspid Annular Displacement by Tissue Doppler in Pulmonary Hypertension.Pulmonary circulation · 2026Article
- Echocardiographic characterization of combined postcapillary and precapillary pulmonary hypertension in systemic sclerosis with preserved ejection fraction.Echo research and practice · 2026Article
- Position Statement on Multimodal Cardiac Imaging in Patients with Systemic Diseases - 2026.Arquivos brasileiros de cardiologia · 2026Article
- Echocardiographic Deformation Imaging of the Right Atrium: A New Paradigm in Noninvasive Hemodynamic Assessment.Current cardiology reports · 2026Review
- Refining Risk Prediction in Systemic Sclerosis-Associated Pulmonary Arterial Hypertension.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2025Article
- Advanced Echocardiographic Assessment Predicts 1-Year Mortality in Critically Ill Patients With Pulmonary Arterial Hypertension.JACC. Advances · 2025Article
- Prognostic Value of the TAPSE/PASP Ratio in Lung Transplant Candidates With Advanced Interstitial Lung Disease.Pulmonary circulation · 2025Article
- Article
- Innovating the Gold Standard: The Emerging Role of Echocardiographic Stress Testing in the Classification, Stratification, and Prognostication in Pulmonary Vascular Disease.Current cardiology reports · 2025Review
- Refining Prognostication and Therapeutic Guidance Through Advances in Right Heart Imaging Approaches.The Canadian journal of cardiology · 2025Review
- Right Ventricular Strain by Echocardiography: Current Clinical Applications and Future Directions for Mechanics Assessment of the Forgotten Ventricle.Journal of personalized medicine · 2025Review
- Myocardial Disease in Systemic Sclerosis: Recent Updates and Clinical Implications.Current cardiology reports · 2025Review
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Authors and funding
15 authors.
Funding
Abstract
backgroundIneffective right ventricular (RV) adaptation to increasing pulmonary arterial (PA) afterload in pulmonary vascular disease (PVD) significantly contributes to morbidity and mortality. Pulmonary vascular disease in systemic sclerosis (SSc) arises through various mechanisms, yet detecting abnormal contractile response remains challenging. Here we examine whether echocardiographic RV-PA coupling metrics correlate with invasive pressure-volume (PV) loops, enhancing the prediction of adverse clinical outcomes in SSc-PVD patients.
methodsProspectively enrolled patients with SSc-PVD with paired echocardiogram and PV loops were included. Linear regression and receiver-operating curve analysis were used to assess the relationship between tricuspid annular plane systolic excursion/PA systolic pressure (PASP), fractional area change/PASP, tissue Doppler velocityS'/PASP, and RV free wall strain (RVFWS)/PASP and coupling thresholds defined by end-systolic to end-arterial elastance (Ees/Ea), obtained by the multibeat method. The contribution of right atrial strain (RAS) to RV-PA coupling parameters was also investigated. Kaplan-Meier analysis was used to identify the relationship between coupling ratios and composite outcomes including clinical worsening, lung transplant, and death.
resultsForty-two patients with SSc were studied, 91% female, with a mean age of 59 ± 12 years and varying degrees of PVD: mean pulmonary artery pressure 29.5 ± 12.8 mm Hg, PVR 4.7 ± 4.2 WU, and PCWP 10.3 ± 4.1 mm Hg. Echocardiographic coupling metrics including tricuspid annular plane systolic excursion/PASP, fractional area change/PASP, tissue Doppler velocity S'/PASP, RVFWS
conclusionEchocardiographic RV-PA coupling ratios strongly correlate with invasive Ees/Ea and predict adverse clinical outcomes in SSc patients across the spectrum of PVD. Further, we demonstrate how RAS impacts RV performance. These findings may refine risk stratification and prognostication in this at-risk cohort.
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