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A. Basics
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C. Arrhythmias and Device Therapy
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E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
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17. Myocardial Disease
18. Pericardial Disease
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Prognostic value of the left atrioventricular coupling index in patients with chronic heart failure: a comparative echocardiographic analysis
Session:
Sessão de Posters 49 - Insuficiência cardíaca para além da fração de ejeção do VE melhorada e recuperada: padrões de recuperação, preditores e marcadores de risco
Speaker:
Rafael Viana
Congress:
CPC 2026
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Rafael Viana; Rita Louro; Cátia Trigo; Joana Vasconcelos; Isabel João; Hélder Pereira
Abstract
<p>Introduction: The left atrioventricular coupling index (LACI), defined as the ratio between minimum left atrial volume and left ventricular end-diastolic volume (LVEDV) may reflect left atrioventricular coupling dysfunction and could potentially serve as a predictor of clinical outcomes. Indeed, prior studies have shown that LACI is independently associated with cardiovascular outcomes in healthy individuals and specific scenarios as after acute myocardial infarction and hypertrophic cardiomyopathy. However, its prognostic significance in patients with chronic heart failure (HF) remains to be fully elucidated.<br /> <br /> Purpose: To evaluate the prognostic value of LACI in patients with chronic HF and to compare its predictive accuracy with other established echocardiographic parameters.<br /> <br /> Methods: Retrospective study. We included consecutive patients with chronic HF referred to the echocardiography laboratory between January 2023 and April 2024. All patients had a minimum follow-up of one year, with the primary prognostic endpoint being a composite of all-cause mortality and HF hospitalization. <br /> <br /> Results: A total of 156 patients were included. Table 1 summarizes baseline characteristics. The mean follow-up duration was 631 ± 227 days.<br /> <br /> During follow-up, 30 patients (19%) met the primary endpoint. Univariate analysis showed that higher E/A ratio (1.9 vs. 0.9; p=0.009), higher E/E’ ratio (13.8 vs. 9.6; p=0.006), higher biplane indexed left atrial volume (BpLAiVol) (66.7 vs. 41.7 mL/m²; p<0.001), higher LACI (0.5 vs. 0.4; p=0.021), lower Left ventricular ejection fraction (LVEF) (32.6% vs. 42.5%; p<0.001) and higher Tricuspid regurgitation maximum velocity (TRvel) (2.9 vs 1.9m/s, p<0.001) and male gender (23% vs. 8%; p=0.029) were associated with the primary outcome. However, only TRvel showed to be an independent predictor for the primary outcome (p=0.032).<br /> <br /> Regarding predictive accuracy, LACI demonstrated moderate discriminative ability, (AUC 0.690). When compared with other parameters, LACI showed inferior performance to E/E’ ratio (AUC 0.730), E/A ratio (AUC 0.726), BpLAiVol (AUC 0.856) and TRvel (AUC 0.856). In comparison with LVEF (based on 1-AUC=0.703), LACI had similar prognostic accuracy.<br /> <br /> Conclusion: In chronic HF, LACI demonstrated moderate prognostic utility in predicting adverse outcomes. Notably, TRvel was identified as an independent predictor of adverse outcomes, underscoring its importance in risk stratification These findings suggest that while LACI provides valuable insights into atrioventricular coupling, its standalone prognostic utility remains limited compared to traditional echocardiographic indices. Integrating TRvel with other parameters may enhance clinical risk assessment, but further prospective studies are needed to validate these findings and optimize prognostic models in chronic HF.</p>
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