The combined atrioventricular coupling index (CACI) independently predicted death, transplant, cardiac arrest, or heart failure hospitalization in dilated cardiomyopathy (HR 2.37, p=0.01).
Cohort (n=121)
Does the combined atrioventricular coupling index (CACI) assessed by 3D echocardiography predict adverse events in patients with dilated cardiomyopathy?
The novel 3D echocardiography-derived combined atrioventricular coupling index (CACI) provides incremental prognostic value over traditional risk factors in patients with dilated cardiomyopathy.
Hazard Ratio: 2.37
p-value: p=0.01
Atrioventricular coupling has recently emerged as an outcome predictor. Our aim was to assess, through three-dimensional (3D) echocardiography, the role of the left atrioventricular coupling index (LACI), right atrioventricular coupling index (RACI) and a novel combined atrioventricular coupling index (CACI) in a cohort of patients with dilated cardiomyopathy (DCM). One hundred twenty-one consecutive patients with DCM underwent comprehensive 3D echocardiographic acquisitions. LACI was defined as the ratio between left atrial and left ventricular 3D end-diastolic volumes. RACI was defined as the ratio between right atrial and right ventricular 3D end-diastolic volumes. CACI was defined as the sum of LACI and RACI. Patients were prospectively followed for death, heart transplant, nonfatal cardiac arrest and hospitalization for heart failure. Fifty-five patients reached the endpoint. All three coupling indices were significantly more impaired in patients with events, with CACI showing the highest area under the curve (AUC = 0.66, p = 0.003). All three indices were independent outcome predictors when tested in multivariable Cox regression (HR = 2.62, p = 0.01 for LACI; HR = 2.58, p = 0.004 for RACI; HR = 2.37, p = 0.01 for CACI), but only CACI showed an incremental prognostic power over traditional risk factors such as age, left ventricular strain, right ventricular strain and mitral regurgitation severity (likelihood ratio χ2 test = 28.2, p = 0.03). CACI assessed through 3D echocardiography, reflecting both left and right atrioventricular coupling, is an independent predictor of adverse events in DCM, yielding an incremental prognostic power over traditional risk factors.
Vijiiac et al. (Sun,) conducted a cohort in Dilated cardiomyopathy (DCM) (n=121). Combined atrioventricular coupling index (CACI) was evaluated on Death, heart transplant, nonfatal cardiac arrest and hospitalization for heart failure (HR 2.37, p=0.01). The combined atrioventricular coupling index (CACI) independently predicted death, transplant, cardiac arrest, or heart failure hospitalization in dilated cardiomyopathy (HR 2.37, p=0.01).