Key result
Higher baseline left atrioventricular coupling index (LACI) was independently associated with an increased risk of major adverse cardiac events after transcatheter aortic valve implantation (HR 1.16).
Why the study?
Preoperative left ventricular diastolic function influences TAVI outcomes, but the prognostic role of the echocardiography-derived left atrioventricular coupling index (LACI) in TAVI remained unclear.
Does an impaired left atrioventricular coupling index (LACI ≥28%) predict major adverse cardiac events in patients undergoing TAVI?
Cohort (n=148)
Single-blind (echocardiography assessors)
No
Does an impaired left atrioventricular coupling index (LACI ≥28%) predict major adverse cardiac events in patients undergoing TAVI?
Answers are grounded in this paper and cite their sources.
A preoperative left atrioventricular coupling index (LACI) ≥28% is an independent echocardiographic predictor of adverse cardiovascular events in patients undergoing TAVI.
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.
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Wu et al. (2025) conducted a cohort in Moderate-to-severe aortic stenosis undergoing transcatheter aortic valve implantation (n=148). Left atrioventricular coupling index (LACI) vs. Lower LACI was evaluated on Major adverse cardiac events (MACEs), a composite of malignant arrhythmia, heart failure rehospitalization, and all-cause mortality (HR 1.16, 95% CI 1.10-1.22, p=<0.001). Higher baseline left atrioventricular coupling index (LACI) was independently associated with an increased risk of major adverse cardiac events after transcatheter aortic valve implantation (HR 1.16).
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