Diagnostic and prognostic value of left atrioventricular coupling index post revascularization in acute coronary syndrome: A two-dimensional echocardiographic study.
The calculation of the left atrioventricular coupling index (LACI) by the ratio between left atrial (LA) and left ventricular (LV) end-diastolic volumes reflects the close interaction between LA and LV.
The study aimed to assess LACI using echocardiography before and after percutaneous coronary intervention (PCI) compared with LV ejection fraction (LV-EF) in acute coronary syndrome (ACS).
This retrospective cohort analysis included 193 ACS patients (65.1 ± 12.5 years, 71.6% males), who underwent PCI. Both LACI and LV-EF were calculated before and after PCI.
At presentation, 156 (80.8%) patients had LV-EF reduction; mild in 61 (39.1%), moderate in 77 (49.3%) and severe in 18 (11.5%). Using LACI < 25% as the cutoff value for normal, 40 (20.7%) patients had impaired LACI. Out of the 153 patients with normal LACI, 127 (83%) had reduced LV-EF. Patients were classified into three groups: I: 51 (26.4%) with STEMI, II: 82 (42.5%) with NSTEMI and III: 60 (31.1%) with unstable angina. Baseline LV-EF and LACI did not show significant differences between the three groups. Over a 12.8 ± 8.2 month follow-up post PCI, LV-EF improved in 68 (43.6%) out of 156 patients becoming normal in 28 (17.9%), mildly reduced in 65 (41.7%), moderately reduced in 55 (35.2%) and severely reduced in 8 (5.1%). Post PCI, LACI normalized in 19 (47.5%) out of 40 patients with impaired baseline LACI.
Assessing LACI in ACS provided a better understanding of LA and LV dynamics and its reduction following PCI indicates a better prognosis.
The study aimed to assess LACI using echocardiography before and after percutaneous coronary intervention (PCI) compared with LV ejection fraction (LV-EF) in acute coronary syndrome (ACS).
This retrospective cohort analysis included 193 ACS patients (65.1 ± 12.5 years, 71.6% males), who underwent PCI. Both LACI and LV-EF were calculated before and after PCI.
At presentation, 156 (80.8%) patients had LV-EF reduction; mild in 61 (39.1%), moderate in 77 (49.3%) and severe in 18 (11.5%). Using LACI < 25% as the cutoff value for normal, 40 (20.7%) patients had impaired LACI. Out of the 153 patients with normal LACI, 127 (83%) had reduced LV-EF. Patients were classified into three groups: I: 51 (26.4%) with STEMI, II: 82 (42.5%) with NSTEMI and III: 60 (31.1%) with unstable angina. Baseline LV-EF and LACI did not show significant differences between the three groups. Over a 12.8 ± 8.2 month follow-up post PCI, LV-EF improved in 68 (43.6%) out of 156 patients becoming normal in 28 (17.9%), mildly reduced in 65 (41.7%), moderately reduced in 55 (35.2%) and severely reduced in 8 (5.1%). Post PCI, LACI normalized in 19 (47.5%) out of 40 patients with impaired baseline LACI.
Assessing LACI in ACS provided a better understanding of LA and LV dynamics and its reduction following PCI indicates a better prognosis.
Authors
Anwar Anwar, Almalki Almalki, Daus Daus, Aladnani Aladnani, Aun Aun, Alzahrani Alzahrani, Ali Ali
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