To the Editor Huston et al1 deserve a standing ovation for their seminal work published in a recent issue of JAMA Cardiology. The association of mild pulmonary hypertension (PH) with right ventricular (RV)–pulmonary artery (PA) coupling, estimated by echocardiography, and its prognostic significance in a large, racially mixed, unselected population lives up to the promise of capturing the big picture of PH and RV-PA interactions.1,2 Despite that noninvasive estimation of RV-PA coupling by the ratio of tricuspid annular plane systolic excursion to PA systolic pressure may not be the most ideal for serial assessment of the critically ill, in whom novel invasive techniques should be validated,3,4 the findings of Huston et al1 leave little doubt in the value of echocardiography as a screening tool.
Mehmood M. Echocardiographic Pulmonary Hypertension and Right Heart Function—The Big Picture. JAMA Cardiol. 2020;5(5):612–613. doi:10.1001/jamacardio.2020.0322
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