We read with interest the article by De Matteis et al. on the prognostic role of the TAPSE/PASP ratio in older patients with HFpEF hospitalized for acute heart failure [1]. The authors show that RV-pulmonary circulation uncoupling (TAPSE/PASP ≤0.36 mm/mmHg) is independently associated with higher in-hospital mortality and with the composite of in-hospital death and 90-day readmission in a very old, multimorbid population. The focus on a real-world cohort and the use of a simple, widely available echocardiographic index that integrates RV function and afterload are clear strengths of the study.
