ArticleEchocardiography (Mount Kisco, N.Y.)2026
Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease.
Article in Echocardiography (Mount Kisco, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to evaluate the all-cause mortality predictive value of left atrioventricular coupling indexes in patients with chronic Chagas disease (CD).
methodsThis single-center retrospective longitudinal study included 382 patients with chronic CD. The left atrioventricular coupling index (LACI) was defined as the ratio of left atrial (LA) over left ventricular (LV) end-diastolic volumes. LA volumetric/mechanical coupling index (LAVI/A') was the ratio of maximum LA volume index over late diastolic mitral annulus velocity. The endpoint was a composite of all-cause mortality or heart transplant. The associations between LACI or LAVI/A' and the endpoint independent from clinical, electrocardiographic, and 2D echocardiographic parameters (Model I) or from Model I adjusting variables plus LV and LA strain parameters (Model II) were tested by multivariate Cox-proportional-hazards regression.
resultsAfter a mean follow-up of 6.6 ± 2.7 years, 80 patients died and two underwent a heart transplant. LACI was associated with the endpoint in Models I (HR 1.03, 95% CI 1.01-1.05, p = 0.01) and II (HR 1.03, 95% CI 1.01-1.05, p = 0.0008). LAVI/A' was also associated with the endpoint in Models I (HR 1.08, 95% CI 1.05-1.12, P < 0.0001) and II (HR 1.09, 95% CI 1.05-1.12, P < 0.0001). The area under the ROC curve was larger for LAVI/A' than LACI (0.87 vs. 0.65, P < 0.0001). The optimal cutoff value for LAVI/A' was 3.3 mL × s/cm
conclusionNew echocardiographic LA coupling indexes are promising predictors of dismal clinical outcomes in CD.
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