What question did this study set out to answer?

This research aims to assess the combined prognostic role of LVGLS and LACI in predicting major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI).

February 8, 2026

Combined left ventricular global longitudinal strain and 3D left atrioventricular coupling index to predict MACE in patients with acute myocardial infarction

Q: What does this research mean for the field?

Combined LVGLS ≥ -11.4% and 3D LACI ≥ 23.5% predict a significantly higher risk of major adverse cardiac events (MACE) in patients with acute myocardial infarction. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Key Result

Combined LVGLS ≥ -11.4% and 3D LACI ≥ 23.5% predicted major adverse cardiac events with AUC 0.812 in acute myocardial infarction patients.

Key Points

This research aims to assess the combined prognostic role of LVGLS and LACI in predicting major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI).
120 consecutive patients with AMI treated by primary PCI were enrolled.
Echocardiography was performed 24 hours after admission.
LVGLS and LACI were calculated using speckle tracking and 3D echocardiography.
MACE was defined as mortality, hospitalization due to heart failure, or reinfarction within 12 months.
Univariate and multivariate COX regression analyses were conducted to determine predictors of MACE.
18.3% of patients experienced MACE within 1 year.
Patients with MACE had significantly lower LVGLS and higher 3D LACI compared to those without MACE.
The combination of LVGLS and 3D LACI provided the highest area under the curve (AUC) for predicting MACE.
LVGLS ≥ -11.4% and 3D LACI ≥ 23.5% were identified as cut-off points for predicting adverse events.
The combination of LVGLS and 3D LACI showed stronger predictive power than either alone.

Structured PICO

Does the combination of left ventricular global longitudinal strain and 3D left atrioventricular coupling index predict MACE in patients with acute myocardial infarction?

Population

120 consecutive patients with acute myocardial infarction (AMI) treated by primary PCI, mean age 66.5 ± 10.2 years, 76.7% men.

Intervention

Assessment of left ventricular global longitudinal strain (LVGLS) by speckle tracking echocardiography and 3D left atrioventricular coupling index (LACI) by 3D echocardiography 24h after admission.

Outcome

Major adverse cardiac events (MACE) including all-cause mortality, hospitalization due to heart failure or reinfarction within 12 months after AMI.composite

The combination of LVGLS and 3D LACI provides superior prognostic value for predicting 1-year MACE in patients with acute myocardial infarction compared to either parameter alone.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Previous studies emphasized the prognostic value of left ventricular global longitudinal strain (LVGLS) and left atrioventricular coupling index (LACI) in patients with acute myocardial infarction (AMI). Purpose We aimed to evaluate the prognostic role of LVGLS assessed by speckle tracking echocardiography, LACI assessed by 3D echocardiography and their combination in patients with AMI. Patients and methods In this study we enrolled 120 consecutive patients with AMI treated by primary PCI. The patients underwent echocardiography 24h after admission. Speckle-tracking strain analysis was used to calculate LVGLS from apical 2-, 3- and 4-chamber views as the mean peak systolic strain of 17 segments. 3D LACI was deﬁned by the ratio of the 3D left atrial end-diastolic volume (minimal atrial volume) divided by the 3D left ventricular end-diastolic volume. Major adverse cardiac events (MACE) including all-cause mortality, hospitalization due to heart failure or reinfarction within 12 months after AMI were deﬁned as primary clinical endpoint. Results Amongst the 120 patients (mean age, 66.5 ± 10.2 years; 76.7% men), 18.3% had MACE during 1-year follow-up. Patients with MACE had lower LVGLS (-10 ± 2.9% vs. -12.6 ± 3.3%, p = 0.001) and higher 3D LACI (23.6 ± 5.4% vs. 18.2 ± 7.3%, p = 0.001). In ROC analysis LVGLS and 3D LACI combined had the best AUC for MACE prediction (AUC 0.812, p 0.001), followed by 3D LACI (AUC 0.794, p 0.001), and then LVGLS (AUC 0.732, p = 0.001). Youden Index identiﬁed an optimal cut-off for each variable, LVGLS ≥ -11.4% and 3D LACI ≥ 23.5% can predict adverse events in patients with AMI. In both univariate and multivariate COX regression analysis, both LVGLS and 3D LACI remained significant predictors of MACE. Furthermore, their combination had stronger predictive power for unfavourable outcome than each taken separately. The patients with the combination of LVGLS ≥ -11.4% and 3D LACI ≥ 23.5% were found to be at extremely high risk for MACE (Log rank, χ2 = 26.1, p 0.001). Conclusion LVGLS and 3D LACI were the independent predictors for MACE in patients with AMI. LVGLS and 3D LACI combined had better predictive value for poor prognosis compared to each variable taken separately.ROC for predicting MACE Kaplan-Meier curves for predicting MACE

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