Prognostic Value of Non-Invasively Determined Right Ventricular–Arterial Coupling Surrogate Parameters in Patients with Dilated Cardiomyopathy

<b>Background/Objectives</b>: Right ventricular dysfunction is frequent in patients with dilated cardiomyopathy (DCM) and contributes significantly to prognosis. This study evaluated the prognostic value of echocardiography-determined surrogate parameters of right ventricular-arterial (RV-PA) coupling in patients with DCM. <b>Methods</b>: A total of 88 patients admitted between January 2019 to September 2023 were retrospectively and prospectively assessed and followed for a mean of 14 months. The primary endpoint was rehospitalization for decompensated heart failure (HF); the secondary endpoint was all-cause mortality. The parameters studied included TAPSE/PASP, RVFAC/PASP, RVFWLS/PASP, and RVEF/PASP. <b>Results</b>: In univariate analysis, all indices were associated with rehospitalization, but multivariate analysis retained only RVFWLS/PASP and RVEF/PASP as independent predictors. Optimal cut-offs were identified as 1.2 for RVEF/PASP (sensitivity 72%, specificity 80%) and 0.46 for RVFWLS/PASP (sensitivity 72%, specificity 76%). None of the parameters correlated significantly with all-cause mortality. <b>Conclusions</b>: These findings highlight the prognostic utility of non-invasively derived RV-PA coupling indices for rehospitalization risk stratification in DCM.