Prognostic value of left atrioventricular coupling index in patients undergoing transcatheter aortic valve implantation: a prospective echocardiographic study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Transcatheter aortic valve implantation (TAVI) is an alternative procedure for patients with symptomatic aortic stenosis who are not suitable candidates for open-heart surgery. Preoperative left ventricular diastolic function influences TAVI outcomes. The left atrioventricular coupling index (LACI) is a novel prognostic indicator in cardiovascular research that is significantly correlated with left ventricular diastolic function. Its role in TAVI remains unclear. The aim of this study was thus to investigate the prognostic value of the echocardiography-derived LACI in predicting major adverse cardiac events (MACEs) after TAVI. Methods: This study included patients with moderate-to-severe aortic stenosis undergoing TAVI (June 2021-December 2024). Preoperative transthoracic echocardiography assessed LACI [defined as left atrial to ventricular end-diastolic volume ratio (LAEDV/LVEDV)], left atrial/ventricular function, and diastolic parameters. Baseline clinical data were systematically collected from electronic medical records. Postoperative MACEs (malignant arrhythmia, heart failure rehospitalization, or all-cause mortality) were tracked via follow-up. Results: 17.43±7.79; P<0.001). Multivariate Cox analysis demonstrated that LACI was significantly associated with MACE occurrence (hazard ratio: 1.16, 95% confidence interval: 1.10-1.22; P<0.001). Receiver operating characteristic analysis suggested that an LACI ≥28% had acceptable sensitivity and specificity for predicting MACEs, and Kaplan-Meier curves revealed a higher MACE incidence among patients with LACI ≥28% (P<0.001). Conclusions: LACI is an independent risk factor for adverse cardiac events in TAVI. Patients exhibiting left atrioventricular decoupling (LACI ≥28%) appear to have an elevated risk of MACEs.
Authors: Bingling Wu, Tongtong Huang, Decai Zeng, Qiong Fang, Yongzhi Cai, Shuai Chang, Yue Li, Huiqiong Luo, Liuliu Huang, Mai Chen, Ji Wu
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416455101