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Updated: Aug 8, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Diagnostic and prognostic value of left atrioventricular coupling index post revascularization in acute coronary
Ashraf M Anwar1,2, Abdelrahman Almalki1, Wesam Daus1
1Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Background:
The calculation of the left atrioventricular coupling index (LACI) by the ratio between left atrial (LA) and left ventricular (LV) end-diastolic volumes reflects the close interaction between LA and LV.
Aim Of The Study:
The study aimed to assess LACI using echocardiography before and after percutaneous coronary intervention (PCI) compared with LV ejection fraction (LV-EF) in acute coronary syndrome (ACS).
Subjects And Methods:
This retrospective cohort analysis included 193 ACS patients (65.1 ± 12.5 years, 71.6% males), who underwent PCI. Both LACI and LV-EF were calculated before and after PCI.
Results:
At presentation, 156 (80.8%) patients had LV-EF reduction; mild in 61 (39.1%), moderate in 77 (49.3%) and severe in 18 (11.5%). Using LACI < 25% as the cutoff value for normal, 40 (20.7%) patients had impaired LACI. Out of the 153 patients with normal LACI, 127 (83%) had reduced LV-EF. Patients were classified into three groups: I: 51 (26.4%) with STEMI, II: 82 (42.5%) with NSTEMI and III: 60 (31.1%) with unstable angina. Baseline LV-EF and LACI did not show significant differences between the three groups. Over a 12.8 ± 8.2 month follow-up post PCI, LV-EF improved in 68 (43.6%) out of 156 patients becoming normal in 28 (17.9%), mildly reduced in 65 (41.7%), moderately reduced in 55 (35.2%) and severely reduced in 8 (5.1%). Post PCI, LACI normalized in 19 (47.5%) out of 40 patients with impaired baseline LACI.
Conclusion:
Assessing LACI in ACS provided a better understanding of LA and LV dynamics and its reduction following PCI indicates a better prognosis.
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