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Cardiac magnetic resonance-derived atrioventricular coupling index for predicting left ventricular reverse remodeling
1Department of Radiology, The First Affiliated Hospital of Wannan Medical College, No.2 Zheshan West Road, Wuhu, Anhui Province, 241001, PR China.
Insights
The cardiac magnetic resonance-derived left atrioventricular coupling index (LACI) effectively predicts left ventricular reverse remodeling (LVRR) in dilated cardiomyopathy (DCM) patients. LACI offers superior or comparable predictive value to strain parameters in clinical models.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Biomarkers
Background:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- Left ventricular reverse remodeling (LVRR) is a key indicator of improved prognosis in DCM patients.
- Predictive markers for LVRR are crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the predictive value of the cardiac magnetic resonance (CMR)-derived left atrioventricular coupling index (LACI) for LVRR in DCM patients.
- To compare the performance of LACI against strain parameters in predicting LVRR.
Main Methods:
- Retrospective analysis of 64 DCM patients receiving guideline-directed therapy.
- Stratification into LVRR and non-LVRR groups based on echocardiographic criteria after one-year follow-up.
- Development and comparison of three multivariable models incorporating LACI, left ventricular strain, or left atrial strain.
Main Results:
- Lower LACI, creatinine, uric acid, and cardiac volumes were observed in the LVRR group (p<0.05).
- Higher ejection fractions and strain parameters were found in the LVRR group (p<0.05).
- LACI independently predicted LVRR (OR=0.585, p=0.009), with a model including LACI showing the highest AUC (0.825).
Conclusions:
- The LACI is a valuable predictor of LVRR in DCM patients.
- LACI demonstrates comparable or superior predictive performance to strain parameters when integrated into clinical and CMR-based models.
- LACI may enhance the prediction of treatment response in DCM.
Aim:
To investigate the value of the cardiac magnetic resonance (CMR)-derived left atrioventricular coupling index (LACI) in predicting left ventricular reverse remodeling (LVRR) in patients with dilated cardiomyopathy (DCM) receiving standardized medical therapy.
Materials And Methods:
This retrospective study enrolled 64 hospitalized DCM patients managed with guideline-directed therapy. Within a one-year follow-up, patients were stratified into LVRR and non-LVRR groups using echocardiographic criteria. Three multivariable models were constructed from predictors identified in univariable analysis (p<0.2), each uniquely integrating either the LACI, left atrial strain, or left ventricular strain. The Delong test was used to compare model performance.
Results:
In our study, the LVRR group exhibited significantly lower LACI, serum creatinine, uric acid, and all cardiac volumetric parameters (left ventricular and atrial volumes) (all p<0.05). Conversely, the LVRR group showed higher left ventricular and atrial ejection fractions, all left ventricular strains, and all left atrial strains (all p<0.05). LACI was an independent predictor of LVRR (odds ratio = 0.585; 95% confidence interval [CI]: 0.391-0.874; p=0.009). The combined model incorporating LACI demonstrated the best predictive performance, with an area under the curve (AUC) of 0.825, outperforming the models incorporating left ventricular strain (AUC = 0.805) or left atrial strain (AUC = 0.791).
Conclusion:
For predicting LVRR in DCM, LACI provides value comparable to or superior to than strain parameters when incorporated into models based on clinical and conventional CMR parameters.
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