Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease.
RM, S., MFF, M., HH, V., MT, H., & AR, C. (2026). Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease.. Echocardiography (Mount Kisco, N.Y.). https://doi.org/10.1111/echo.70560
RM S, MFF M, HH V, MT H, AR C. Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease.. Echocardiography (Mount Kisco, N.Y.). 2026; doi: 10.1111/echo.70560
RM S, MFF M, HH V, et al. Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease.[J]. Echocardiography (Mount Kisco, N.Y.). 2026. DOI: 10.1111/echo.70560.
@article{rm2026,
author = {Saraiva RM and Mediano MFF and Veloso HH and Holanda MT and Costa AR},
title = {Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease.},
journal = {Echocardiography (Mount Kisco, N.Y.)},
year = {2026},
doi = {10.1111/echo.70560},
note = {PMID: 42525489},
}
TY - JOUR AU - Saraiva RM AU - Mediano MFF AU - Veloso HH AU - Holanda MT AU - Costa AR TI - Left Atrial Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease. T2 - Echocardiography (Mount Kisco, N.Y.) PY - 2026 DO - 10.1111/echo.70560 AN - PMID:42525489 ER -
PURPOSE: This study aimed to evaluate the all-cause mortality predictive value of left atrioventricular coupling indexes in patients with chronic Chagas disease (CD). METHODS: This single-center retrospective longitudinal study included 382 patients with chronic CD. The left atrioventricular coupling index (LACI) was defined as the ratio of left atrial (LA) over left ventricular (LV) end-diastolic volumes. LA volumetric/mechanical coupling index (LAVI/A') was the ratio of maximum LA volume index over late diastolic mitral annulus velocity. The endpoint was a composite of all-cause mortality or heart transplant. The associations between LACI or LAVI/A' and the endpoint independent from clinical, electrocardiographic, and 2D echocardiographic parameters (Model I) or from Model I adjusting variables plus LV and LA strain parameters (Model II) were tested by multivariate Cox-proportional-hazards regression. RESULTS: After a mean follow-up of 6.6 ± 2.7 years, 80 patients died and two underwent a heart transplant. LACI was associated with the endpoint in Models I (HR 1.03, 95% CI 1.01-1.05, p = 0.01) and II (HR 1.03, 95% CI 1.01-1.05, p = 0.0008). LAVI/A' was also associated with the endpoint in Models I (HR 1.08, 95% CI 1.05-1.12, P < 0.0001) and II (HR 1.09, 95% CI 1.05-1.12, P < 0.0001). The area under the ROC curve was larger for LAVI/A' than LACI (0.87 vs. 0.65, P < 0.0001). The optimal cutoff value for LAVI/A' was 3.3 mL × s/cm-1 per m2 (sensitivity 81.7%, specificity 83.7%). Patients with LAVI/A' ≥ 3.3 at baseline had a 19-fold higher risk for all-cause mortality. CONCLUSION: New echocardiographic LA coupling indexes are promising predictors of dismal clinical outcomes in CD.