PMID- 38397904 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240227 IS - 2227-9059 (Print) IS - 2227-9059 (Electronic) IS - 2227-9059 (Linking) VI - 12 IP - 2 DP - 2024 Jan 28 TI - Three-Dimensional Combined Atrioventricular Coupling Index-A Novel Prognostic Marker in Dilated Cardiomyopathy. LID - 10.3390/biomedicines12020302 [doi] LID - 302 AB - Atrioventricular coupling has recently emerged as an outcome predictor. Our aim was to assess, through three-dimensional (3D) echocardiography, the role of the left atrioventricular coupling index (LACI), right atrioventricular coupling index (RACI) and a novel combined atrioventricular coupling index (CACI) in a cohort of patients with dilated cardiomyopathy (DCM). One hundred twenty-one consecutive patients with DCM underwent comprehensive 3D echocardiographic acquisitions. LACI was defined as the ratio between left atrial and left ventricular 3D end-diastolic volumes. RACI was defined as the ratio between right atrial and right ventricular 3D end-diastolic volumes. CACI was defined as the sum of LACI and RACI. Patients were prospectively followed for death, heart transplant, nonfatal cardiac arrest and hospitalization for heart failure. Fifty-five patients reached the endpoint. All three coupling indices were significantly more impaired in patients with events, with CACI showing the highest area under the curve (AUC = 0.66, p = 0.003). All three indices were independent outcome predictors when tested in multivariable Cox regression (HR = 2.62, p = 0.01 for LACI; HR = 2.58, p = 0.004 for RACI; HR = 2.37, p = 0.01 for CACI), but only CACI showed an incremental prognostic power over traditional risk factors such as age, left ventricular strain, right ventricular strain and mitral regurgitation severity (likelihood ratio chi(2) test = 28.2, p = 0.03). CACI assessed through 3D echocardiography, reflecting both left and right atrioventricular coupling, is an independent predictor of adverse events in DCM, yielding an incremental prognostic power over traditional risk factors. FAU - Vijiiac, Aura AU - Vijiiac A AUID- ORCID: 0000-0002-5010-3433 AD - Cardiology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. FAU - Scarlatescu, Alina Ioana AU - Scarlatescu AI AUID- ORCID: 0000-0003-2183-5771 AD - Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania. FAU - Petre, Ioana Gabriela AU - Petre IG AD - Cardiology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania. FAU - Vijiiac, Cristian AU - Vijiiac C AD - Emergency County Hospital Ploiesti, 100097 Ploiesti, Romania. FAU - Vatasescu, Radu Gabriel AU - Vatasescu RG AUID- ORCID: 0000-0001-7163-8528 AD - Cardiology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania. LA - eng PT - Journal Article DEP - 20240128 PL - Switzerland TA - Biomedicines JT - Biomedicines JID - 101691304 PMC - PMC10886977 OTO - NOTNLM OT - atrioventricular coupling OT - combined atrioventricular coupling index OT - dilated cardiomyopathy OT - three-dimensional echocardiography COIS- The authors declare no conflicts of interest. EDAT- 2024/02/24 11:44 MHDA- 2024/02/24 11:45 PMCR- 2024/01/28 CRDT- 2024/02/24 01:10 PHST- 2023/12/11 00:00 [received] PHST- 2024/01/24 00:00 [revised] PHST- 2024/01/26 00:00 [accepted] PHST- 2024/02/24 11:45 [medline] PHST- 2024/02/24 11:44 [pubmed] PHST- 2024/02/24 01:10 [entrez] PHST- 2024/01/28 00:00 [pmc-release] AID - biomedicines12020302 [pii] AID - biomedicines-12-00302 [pii] AID - 10.3390/biomedicines12020302 [doi] PST - epublish SO - Biomedicines. 2024 Jan 28;12(2):302. doi: 10.3390/biomedicines12020302.