Left Atrioventricular Coupling Index to Predict Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis

Figures

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  Figure 1. Flowchart of the study. (1) Mean time between baseline and second CMR exams: 9.6 ± 0.6 years. (2). Mean time of HF follow-up: 6.8 ± 1.3 years after the second CMR exam. AF, atrial fibrillation; CMR, cardiovascular magnetic resonance; HF, heart failure; MI, myocardial infarction.

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  Figure 2. Method to assess the Left Atrio-ventricular Coupling Index (LACI) by CMR. The LACI was defined by the ratio between the LA end-diastolic volume and the LV end-diastolic volume. A stack of short-axis cine images was acquired to encompass both ventricles and LV end-diastolic volume was measured using cardiac image modeler (CIM) software (green volume, left panel). LA end-diastolic volume was measured using multimodality tissue-tracking (MTT) software to track LA wall motion during the end-diastole in the 4-chamber and 2-chamber views (pink borders, right panel). CMR, cardiovascular magnetic resonance; LA, left atrial; LACI, left atrioventricular coupling index; LV, left ventricle.

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  Figure 3. Kaplan-Meier survival curves for incident HF stratified by LACI terciles (A) and by a LACI cut-off of 30% (B). (A) The cumulative hazard was significantly greater in the 3th LACI10−years tercile compared with the other terciles for incident HF (log-rank for difference; p < 0.001). (B) The cumulative hazard was significantly greater for patients with LACI10−years >30% compared with patients with LACI10−years ≤ 30% for incident HF (log-rank for difference; p < 0.001). HF, heart failure; LACI, left atrioventricular coupling index.

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  Figure 4. Kaplan-Meier survival curves for incident HF stratified by terciles of ΔLACI (A) and by ΔLACI with a cut-off of 1.5%/year (B). (A) The cumulative hazard was significantly greater in the 3th tercile compared with the other terciles for incident HF (log-rank for difference; p < 0.001). (B) The cumulative hazard was significantly greater for patients with ΔLACI >1.5%/year compared with patients with ΔLACI ≤ 1.5%/year for incident HF (log-rank for difference; p < 0.001). Δ, annual change; HF, heart failure; LACI, left atrioventricular coupling index.