Normal Values of Echocardiographic Left Atrioventricular Coupling Index and Left Atrial Stiffness Index Reflecting...

Area of Science:

• Cardiology
• Cardiac Physiology
• Echocardiography

Background:

• The left atrioventricular coupling index (LACI) and left atrial stiffness index (LASI) show promise in assessing left ventricular (LV) diastolic function.
• Lack of established reference ranges hinders the clinical application of LACI and LASI.
• This study aimed to define normal reference values for LACI and LASI.

Purpose of the Study:

• To establish sex- and age-stratified normal reference ranges for LACI and LASI.
• To identify factors influencing LACI and LASI.
• To explore the potential of LACI and LASI in detecting early cardiac dysfunction.

Main Methods:

• 1,648 healthy participants from 55 centers were analyzed.
• LACI was calculated as the ratio of minimum left atrial (LA) volume to LV end-diastolic volume.
• LASI was determined by the ratio of average E/e' to LA reservoir strain.

Main Results:

• Both LACI and LASI increased with age in both sexes; LACI was higher in women.
• Independent predictors for LACI included age, sex, LV global longitudinal strain (GLS), and LA reservoir strain.
• Age, BMI, LV GLS, and LA volume index were associated with LASI; elevated values seen in participants with high-normal blood pressure, overweight status, and indeterminate LV diastolic function.

Conclusions:

• Sex- and age-specific reference values for LACI and LASI have been successfully established.
• LV GLS, LA reservoir strain, and LA volume index are important considerations for interpreting LACI and LASI.
• LACI and LASI may serve as valuable indicators for identifying early cardiac dysfunction, particularly in the context of hypertension, obesity, and LV diastolic dysfunction.