Left atrioventricular coupling index assessed with three-dimensional echocardiography: a prognostic marker of short-term outcomes in light-chain cardiac amyloidosis

作者：Fangmin Meng, Jing Li, Rui Zhao, Yuanfeng Wu, Yu Liu, Yiming Yang, Yang Yang, Nianwei Zhou, Lili Dong, Dehong Kong, Haiyan Chen, Xianhong Shu, Peng Liu, Cuizhen Pan · 发表于：Amyloid · 年份：2025 · DOI：10.1080/13506129.2024.2448435 · 被引用次数：12 · 研究领域：Amyloidosis: Diagnosis, Treatment, Outcomes、Cardiovascular Function and Risk Factors、Cardiac Imaging and Diagnostics

Background Light-chain cardiac amyloidosis (AL-CA) is associated with structural and functional changes in the left atrium and left ventricle. This study aims to assess the value of the left atrioventricular coupling index (LACI) assessed by three-dimensional echocardiography (3DE) for predicting primary outcome in AL-CA.Methods Participants with biopsy-confirmed AL-CA from April 2022 to February 2024 were prospectively analysed. LACI, the ratio of left atrial volume min to left ventricular end-diastolic volumes, was calculated offline using EchoPAC 204. The primary outcome was defined as all-cause death.Results Sixty-seven biopsy-proven AL-CA patients were studied (age: 62.98 ± 10.20 years; 67% male). The median follow-up was 121 days (range: 7 ∼ 732 days). All-cause mortality occurred in 26 (39%) patients. Multivariate Cox regression revealed a significant association of LACI after adjusting for NT-pro BNP, troponin T, moderate tricuspid regurgitation, pericardial and pleural effusion (adjusted HR: 10.58, p = 0.008). Kaplan-Meier curves displayed prognostic differences based on median LACI (cut-off : 0.57, p = 0.002). The likelihood ratio χ2 test showed that LACI added predictive value to Mayo 2004, European 2015 modification of Mayo 2004, and Mayo 2012 models (All p < 0.001).Conclusions 3DE-based LACI is independently associated with all-cause mortality in AL-CA patients and augments prognostic value to traditional staging models.