PMID- 34540915 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221006 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 8 DP - 2021 TI - Left Atrioventricular Coupling Index to Predict Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis. PG - 704611 LID - 10.3389/fcvm.2021.704611 [doi] LID - 704611 AB - Background: Although left atrial (LA) and left ventricular (LV) structural and functional parameters have independent prognostic value as predictors of heart failure (HF), the close physiological relationship between the LA and LV suggest that the assessment of LA/LV coupling could better reflect left atrioventricular dysfunction and be a better predictor of HF. Aim: We investigated the prognostic value of a left atrioventricular coupling index (LACI), measured by cardiovascular magnetic resonance (CMR), as well as change in LACI to predict incident HF in the Multi-Ethnic Study of Atherosclerosis (MESA). Materials and Methods: In the MESA, 2,250 study participants, free of clinically recognized HF and cardiovascular disease (CVD) at baseline, had LACI assessed by CMR imaging at baseline (Exam 1, 2000-2002), and 10 years later (Exam 5, 2010-2012). Left atrioventricular coupling index was defined as the ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox proportional hazard models were used to evaluate the associations of LACI and average annualized change in LACI (DeltaLACI) with incident HF after adjustment for traditional MESA-HF risk factors. The incremental risk prediction was calculated using C-statistic, categorical net reclassification index (NRI) and integrative discrimination index (IDI). Results: Among the 2,250 participants (mean age 59.3 +/- 9.3 years and 47.6% male participants), 50 incident HF events occurred over 6.8 +/- 1.3 years after the second CMR exam. After adjustment, greater LACI and DeltaLACI were independently associated with HF (adjusted HR 1.44, 95% CI [1.25-1.66] and adjusted HR 1.55, 95% CI [1.30-1.85], respectively; both p < 0.0001). Adjusted models for LACI showed significant improvement in model discrimination and reclassification compared to currently used HF risk score model for predicting HF incidence (C-statistic: 0.81 vs. 0.77; NRI = 0.411; IDI = 0.043). After adjustment, DeltaLACI showed also significant improvement in model discrimination compared to the multivariable model with traditional MESA-HF risk factors for predicting incident HF (C-statistic: 0.82 vs. 0.77; NRI = 0.491; IDI = 0.058). Conclusions: In a multi-ethnic population, atrioventricular coupling (LACI), and coupling change (DeltaLACI) are independently associated with incident HF. Both have incremental prognostic value for predicting HF events over traditional HF risk factors. CI - Copyright (c) 2021 Pezel, Ambale Venkatesh, Kato, De Vasconcellos, Heckbert, Wu, Post, Bluemke, Cohen-Solal, Henry and Lima. FAU - Pezel, Theo AU - Pezel T AD - Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD, United States. AD - Department of Cardiology, Lariboisiere Hospital - Assistance Publique des Hopitaux de Paris (APHP), Inserm UMRS 942, University of Paris, Paris, France. FAU - Ambale Venkatesh, Bharath AU - Ambale Venkatesh B AD - Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD, United States. FAU - Kato, Yoko AU - Kato Y AD - Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD, United States. FAU - De Vasconcellos, Henrique Doria AU - De Vasconcellos HD AD - Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD, United States. FAU - Heckbert, Susan R AU - Heckbert SR AD - Department of Epidemiology, University of Washington, Seattle, WA, United States. FAU - Wu, Colin O AU - Wu CO AD - Division of Intramural Research, National Heart Lung and Blood Institute, Bethesda, MD, United States. FAU - Post, Wendy S AU - Post WS AD - Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD, United States. FAU - Bluemke, David A AU - Bluemke DA AD - Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States. FAU - Cohen-Solal, Alain AU - Cohen-Solal A AD - Department of Cardiology, Lariboisiere Hospital - Assistance Publique des Hopitaux de Paris (APHP), Inserm UMRS 942, University of Paris, Paris, France. FAU - Henry, Patrick AU - Henry P AD - Department of Cardiology, Lariboisiere Hospital - Assistance Publique des Hopitaux de Paris (APHP), Inserm UMRS 942, University of Paris, Paris, France. FAU - Lima, Joao A C AU - Lima JAC AD - Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD, United States. LA - eng GR - R01 HL127659/HL/NHLBI NIH HHS/United States PT - Journal Article DEP - 20210901 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC8442844 OTO - NOTNLM OT - cardiac magnetic resonance image OT - coupling OT - heart failure OT - left atria OT - left ventricle OT - multi-ethnic study of atherosclerosis OT - prognosis COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/09/21 06:00 MHDA- 2021/09/21 06:01 PMCR- 2021/01/01 CRDT- 2021/09/20 06:14 PHST- 2021/05/03 00:00 [received] PHST- 2021/08/13 00:00 [accepted] PHST- 2021/09/20 06:14 [entrez] PHST- 2021/09/21 06:00 [pubmed] PHST- 2021/09/21 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2021.704611 [doi] PST - epublish SO - Front Cardiovasc Med. 2021 Sep 1;8:704611. doi: 10.3389/fcvm.2021.704611. eCollection 2021.