Conclusions

Ventriculo-arterial coupling integrates ventricular contractile performance with arterial load and stroke volume generation, providing a physiological framework that extends beyond blood pressure, cardiac output, and ejection fraction alone. It may help distinguish impaired contractility, excessive afterload, vasoplegia, preload limitation, and inefficient ventricular-arterial interaction in septic shock, heart failure, perioperative instability, and selected pediatric conditions. Its principal current value is as an adjunctive tool for interpreting hemodynamic status and treatment response rather than as an independent therapeutic target. Clinical application remains limited by methodological variability, simplified measurement assumptions, and incomplete validation of noninvasive indices in rapidly changing states. Future research should standardize measurement protocols, establish population-specific thresholds, and determine whether coupling-guided management improves perfusion, therapeutic response, and patient-centered outcomes.