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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Published on: July 20, 2022

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
PubMed

Insights

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.
Abstract

Keywords:
Chagas diseaseleft atrial functionmortalityprognosis

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