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Left Atrial Coupling Index Predicts Heart Failure in Patients with End Stage Renal Disease
Fulya Avcı Demir1,2, Gülsüm Bingöl3,4, Mustafa Uçar5
1Department of Cardiology, Medical Park Hospital, 07160 Antalya, Turkey.
Insights
The left atrial coupling index (LACI) effectively predicts heart failure with preserved ejection fraction (HFpEF) in end-stage renal disease (ESRD) patients. This simple echocardiographic measure offers valuable insights for clinical practice.
Area of Science:
- Cardiology
- Nephrology
- Echocardiography
Background:
- End-stage renal disease (ESRD) significantly increases cardiovascular risk.
- Heart failure with preserved ejection fraction (HFpEF) is a common complication in ESRD patients.
- Predictive markers for HFpEF in ESRD are crucial for early intervention.
Purpose of the Study:
- To evaluate the predictive capability of the left atrial coupling index (LACI) for HFpEF in ESRD patients.
- To compare LACI's predictive power against other echocardiographic parameters.
- To assess the clinical utility of LACI in routine practice.
Main Methods:
- Retrospective study of 100 non-dialysis ESRD patients (18-65 years).
- Patients categorized into HFpEF and non-HFpEF groups.
- LACI calculated as Left Atrial Volume Index (LAVI) / a' wave (Tissue Doppler Imaging).
- Statistical analysis included univariate and multivariate regression.
Main Results:
- Patients with HFpEF showed significantly higher LACI values.
- LACI demonstrated superior predictive capacity for HFpEF compared to LAVI and other echocardiographic measures.
- Regression analyses confirmed LACI as a strong independent predictor.
Conclusions:
- Elevated LACI levels are strongly associated with the presence of HFpEF in ESRD.
- LACI is a readily obtainable and valuable echocardiographic marker for HFpEF assessment in ESRD.
- The findings support LACI's integration into routine echocardiographic evaluations for this population.
Abstract:
Background and Objectives: We aimed to ascertain the predictive power of the left atrial coupling index (LACI) in patients with end stage renal disease (ESRD) for heart failure with preserved ejection fraction (HFpEF). Materials and Methods: This is a retrospective study including 100 subjects between 18 and 65 years of age with ESRD and not on dialysis treatment. Patients were divided into groups with and without HFpEF. The LACI was defined as the ratio of the left atrial volume index (LAVI) to the a' wave in tissue Doppler imaging (TDI). Statistical analyses were performed, including univariate and multivariate regression analyses. Results: The mean age of the participants was 47 ± 13.3 years. Individuals with HFpEF exhibited a higher LACI. Univariate and multivariate regression analyses demonstrated that the predictive capacity of the LACI for HFpEF was considerably higher than that of the LAVI and other echocardiographic parameters. Conclusions: Higher LACI levels were consistently related to the presence of HFpEF in ESRD patients. The LACI can be easily obtained in daily practice using conventional Doppler echocardiographic measurements during left atrial functional assessments.
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