“…5 Interestingly, the same guidelines did not recommend more reliable volume-or pressure-based methods for its calculation with echocardiography, magnetic resonance imaging, or RHC. 21,25,30,31 This reservation may reflect the limitations of the concept originating from its complicated nature and the assumptions needed for its calculation. Aside from its impracticality, ventriculoarterial coupling may also have a limited predictive power for mortality because of the considerable RV coupling reserve that sustains enough energy transfer for the maintenance of the normal circulation until the later stages of the disease.…”