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Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease
Roberto M Saraiva1, Mauro Felippe F Mediano1, Henrique H Veloso1
1Clinical Research Laboratory in Chagas Disease, Oswaldo Cruz Foundation, Fiocruz, Evandro Chagas National Institute of Infectious Diseases, Rio de Janeiro, Rio de Janeiro, Brazil.
Echocardiography (Mount Kisco, N.Y.)
|July 29, 2026
Summary
New echocardiographic indexes predict mortality in Chagas disease (CD) patients. The LA volumetric/mechanical coupling index (LAVI/A’) is a strong predictor of all-cause mortality, with higher values indicating increased risk.
Area of Science:
- Cardiology
- Echocardiography
- Chagas Disease Research
Background:
- Chronic Chagas disease (CD) poses a significant risk for cardiovascular complications and mortality.
- Predictive markers for adverse outcomes in CD patients are crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive value of left atrioventricular coupling indexes for all-cause mortality in chronic Chagas disease patients.
- To assess the performance of left atrial (LA) over left ventricular (LV) end-diastolic volumes (LACI) and LA volumetric/mechanical coupling index (LAVI/A') in predicting mortality.
Main Methods:
- A retrospective longitudinal study of 382 chronic CD patients.
- Calculation of LACI (LA/LV end-diastolic volumes) and LAVI/A' (max LA volume index / late diastolic mitral annulus velocity).
- Multivariate Cox-proportional-hazards regression analysis to assess associations with all-cause mortality or heart transplant, adjusting for clinical and echocardiographic parameters.
Main Results:
- After a mean follow-up of 6.6 years, 80 deaths and 2 heart transplants occurred.
- Both LACI and LAVI/A' were significantly associated with the endpoint in multivariate analyses.
- LAVI/A' demonstrated superior predictive performance (AUC 0.87 vs. 0.65) and identified patients with a 19-fold higher mortality risk at a cutoff of 3.3 mL×s/cm-1/m2.
Conclusions:
- Novel echocardiographic left atrial coupling indexes, particularly LAVI/A', show significant promise.
- These indexes can effectively predict dismal clinical outcomes, including all-cause mortality, in patients with chronic Chagas disease.
- LAVI/A' may serve as a valuable tool for risk stratification in CD management.
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