Objective:To investigate the value of cardiac magnetic resonance(CMR)based right ventricular-pulmonary arterial coupling(VAC)parameters in assessing risk stratification of connective tissue disease-related pulmonary hypertension(CTD-PH). Methods:The clinical and CMR data of 62 patients with CTD-PH between June 2018 and April 2022 were retrospectively analyzed, and they were divided into group 1(low-risk and low-to-moderate-risk patients,n=39)and group 2(moderate-to-high-risk and high-risk patients,n=23)according to risk stratification,and the patients’right and left ventricle-related volumetric and functional parameters, left ventricular tissue characterization parameters and VAC were statistically analyzed. The optimal model was sought to predict CTD- PH risk stratification. Results:The differences in right ventricle-related volumetric and functional parameters,and tissue characterization parameters of the right ventricular insertion were statistically significant in the two groups of patients with CTD -PH (P < 0.05). The right ventricular end-diastolic point(RVIP)volume index(RVEDVI)and VAC were independent predictors,and the combination of RVEDVI and VAC had the best predictive accuracy(AUC=0.839,95% CI:0.735~0.944,P < 0.001). Conclusion: Right ventricle-related volumetric and functional parameters,and RVIP tissue characterization parameters can be used to assess CTD- PH risk stratification;the combination of RVEDVI and VAC improves the accuracy of assessing risk stratification.