ObjectivesThe aim of the study was to evaluate the correlation between cardiopulmonary exercise testing (CPET) parameters and right ventricular echocardiographic parameters for pulmonary arterial hypertension screening in a cohort of systemic sclerosis (SSc) patients.Methodsforty SSc patients were examined using CPET and resting transthoracic echocardiography. CPET parameters analyzed were minute ventilation/carbon dioxide production (VE/VCO2) slope and maximum oxygen uptake (VO2max); echocardiographic parameters were systolic pulmonary artery pressure (sPAP), tricuspid annular plane systolic excursion (TAPSE), and TAPSE/sPAP ratio.Resultsa positive correlation was observed between VE/VCO2slope and age (r= 0.415,p< 0.01) and sPAP (r= 0.461,p< 0.01), conversely, a negative correlation was found between VE/VCO2slope and TASPE/sPAP ratio (r= − 0.521,p= 0.001). VO2max showed an inverse correlation with age (r= − 0.367,p< 0.05) and sPAP (r= − 0.387,p< 0.05) and a positive correlation with TAPSE/sPAP ratio (r= 0.521,p< 0.01). On stepwise linear regression analysis, VE/VCO2slope was significantly correlated with TAPSE/sPAP ratio (βcoefficient = − 0.570;p< 0.0001), as well as VO2max was significantly correlated with TAPSE/sPAP ratio (βcoefficient = 0.518;p= 0.001).Conclusionin SSc patients, TAPSE/sPAP ratio is the echocardiographic parameter of RV function which showed the best correlation with ventilatory efficiency and exercise capacity.