Imamura T, Narang N, Kim G, et al. - Given decoupling between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure represents an index of pulmonary vascular damage, researchers evaluated how decoupling can influence right heart function and hemocompatibility‐associated adverse events in this prospective analysis. After left ventricular assist device implantation, invasive hemodynamic tests were performed on patients. They defined decoupling as a difference of > 5 mm Hg between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure. The decoupling group vs the control group showed worsening of right heart function and size by echocardiographic evaluation during a 1‐year observational span. Significantly lower 1‐year freedom from any hemocompatibility‐related adverse events and a higher hemocompatibility score was found in the decoupling group. Using 4 escalating tiers, the severity of hemocompatibility‐associated adverse events was defined by the scoring system. Overall, in patients with left ventricular assist devices, worsening of right heart function and hemocompatibility‐related adverse events were observed in relation to the presence of decoupling between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure.