Cardiac magnetic resonance-derived left atrioventricular coupling index predicts outcome in reduced ejection fraction

Figure 1. Flowchart of the study. CMR, cardiac magnetic resonance; HF, heart failure; LA, left atrium; LACI, left atrioventricular coupling index

Figure 2. Schematic representation of left atrioventricular coupling index calculation (LACI). LVEDV, left ventricle end-diastolic volume; LAEDV, left atrial end-diastolic volume

Figure 3. Violin plots illustrating the distribution of left atrioventricular coupling index (LACI) according to all-cause mortality (A), all-cause mortality or heart failure (B), and heart failure (C). ACM, all-cause mortality; HF, heart failure

Figure 4. Kaplan–Meier curves showing event-free survival rates according to left atrioventricular coupling index (LACI) ≥21% for all-cause mortality (A) and all-cause mortality or heart failure (B)

Figure 5. Cumulative incidence function curve for HF occurrence and accounting for competing risk of all-cause mortality according to left atrioventricular coupling index (LACI) ≥21%. 95% CI, 95% confidence intervals; SHR, subhazard ratio

Figure 6. Incremental value of left atrioventricular coupling index (LACI) on top of previously developed DERIVATE scores for (A) non-ischaemic (NICM) and (B) ischaemic cardiomyopathy (ICM) and echocardiography-derived left ventricle ejection fraction (TTE-derived LVEF). NICM-DERIVATE score is calculated as the sum of 2 points for male sex, 3 points if left ventricle end-diastolic volume index >120.5 mL/m2, and 2 points for the presence of >3 segments of midwall fibrosis. ICM-DERIVATE score is calculated as 0.005 * (left ventricle end-diastolic volume index [mL/m2])—0.029 * (left ventricle ejection fraction [%]) + 0.010 * (late gadolinium enhancement mass [g]). The likelihood-ratio test was used for comparison of all-cause mortality and the composite of all-cause mortality and heart failure. The Wald test was used for comparison of models predicting heart failure with competing risk